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Sample records for arthropathy neurogenic

  1. Nodular osteochondrogenic activity in soft tissue surrounding osteoma in neurogenic para osteo-arthropathy: morphological and immunohistochemical study

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    Denys P

    2004-11-01

    Full Text Available Abstract Background Neurogenic Para-Osteo-Arthropathy (NPOA occurs as a consequence of central nervous system injuries or some systemic conditions. They are characterized by bone formation around the main joints. Methods In order to define some biological features of NPOAs, histological and immunohistological studies of the soft tissue surrounding osteoma and Ultrasound examination (US of NPOA before the appearance of abnormal ossification on plain radiographs were performed. Results We have observed a great number of ossifying areas scattered in soft tissues. US examination have also shown scattered ossifying areas at the early stage of ossification. A high osteogenic activity was detected in these tissues and all the stages of the endochondral process were observed. Mesenchymal cells undergo chondrocytic differentiation to further terminal maturation with hypertrophy, which sustains mineralization followed by endochondral ossification process. Conclusion We suggest that periosteoma soft tissue reflect early stage of osteoma formation and could be a model to study the mechanism of osteoma formation and we propose a mechanism of the NPOA formation in which sympathetic dystony and altered mechanical loading induce changes which could be responsible for the cascade of cellular events leading to cartilage and bone formation.

  2. [Charcot's arthropathy

    DEFF Research Database (Denmark)

    Christensen, T.M.; Yderstraede, K.; Ejskjaer, N.;

    2008-01-01

    Charcot's arthropathy is a rare complication to diabetes with peripheral neuropathy. The diagnosis is based on a red, oedematous foot with 2 degrees C difference in skin temperature between the affected foot compared to the unaffected foot. The condition is characterised by fractures, dislocation...... of joints and deformity. The treatment is off-loading. When the off-loading treatment is completed, the patient should gradually adjust to wearing bespoken shoes. Lifelong control of the feet and shoes is necessary Udgivelsesdato: 2008/8/11...

  3. Enteropathic Arthropathy

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    R. Basiratnia

    2005-08-01

    Full Text Available Introduction & Background: In recent years, muscu-loskeletal manifestations of gasterointestinal diseases are increasingly diagnosed and described. These manifestations are collectively referred to as en-teropathic arthropathy, due to their close relationship with the intestinal manifestations. Rheumatologic manifestations of three important GI diseases ulcera-tive colitis (UC, Crohn’s disease and Whipple’s dis-ease are well described. Moreover, musculoskeletal disorders were described following some intestinal infections by different bacteria, especially salmonella, shigella, and yerssinia after bypass surgery or as side effects of extraintestinal diseases like laennec cirrho-sis, primary biliary cirrhosis and pancreatitis. Due to the increase in the prevalence of intestinal and he-patic diseases and the improvement in life expectancy of patients in recent years, it seems justifiable to evaluate musculoskeletal manifestations and to be-come more familiar with their specific characteristics.

  4. Hemophilic arthropathy

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    Sham Santhanam

    2015-01-01

    Full Text Available A 16-year-old boy, born through non-consanguineous marriage, presented with acute onset of left knee joint pain and swelling with no history of fever or trauma. He was a known case of hemophilia A with recurrent attacks of hemarthrosis since 3 years of age involving only the knee joints. His symptoms used to subside when receiving multiple (on demand factor VIII infusions. Clinical examination revealed that the joints were warm, tender, and swollen. His knee radiography revealed subchondral cysts, widening of intercondylar notch, soft tissue swelling, flattened intercondylar surfaces, erosions, generalized osteopenia on anteroposterior view, and squaring of patella on lateral view (Fig.1 and 2. The findings were suggestive of chronic hemophilic arthropathy.

  5. Neurogenic Bladder

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    Peter T. Dorsher

    2012-01-01

    Full Text Available Congenital anomalies such as meningomyelocele and diseases/damage of the central, peripheral, or autonomic nervous systems may produce neurogenic bladder dysfunction, which untreated can result in progressive renal damage, adverse physical effects including decubiti and urinary tract infections, and psychological and social sequelae related to urinary incontinence. A comprehensive bladder-retraining program that incorporates appropriate education, training, medication, and surgical interventions can mitigate the adverse consequences of neurogenic bladder dysfunction and improve both quantity and quality of life. The goals of bladder retraining for neurogenic bladder dysfunction are prevention of urinary incontinence, urinary tract infections, detrusor overdistension, and progressive upper urinary tract damage due to chronic, excessive detrusor pressures. Understanding the physiology and pathophysiology of micturition is essential to select appropriate pharmacologic and surgical interventions to achieve these goals. Future perspectives on potential pharmacological, surgical, and regenerative medicine options for treating neurogenic bladder dysfunction are also presented.

  6. The acromegalic arthropathy.

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    Colao, A; Pivonello, R; Scarpa, R; Vallone, G; Ruosi, C; Lombardi, G

    2005-01-01

    Since the initial definition of acromegaly over 100 yr ago, extraordinary efforts have been made to control GH levels and the pituitary tumor. Criteria of cure have been evolving constantly and all previous statements should be revised according to modern criteria of disease control. Arthropathy is undoubtedly the most important cause of morbidity and functional disability of acromegaly, and bone alterations are highly characteristic of this syndrome. They involve theoretically all bones and, particularly, the appendicular and the axial skeleton. Radiographic changes at different joint sites are more common than symptoms related to their involvement. There is a progression in the acromegalic arthropathy, resembling that described for the acromegalic cardiomyopathy or for the acromegalic features at other organs, such as thyroid, breast and prostate. At early stage, cartilage hypertrophy predominates, and then degenerative changes start until osteoarthritis features occur. Arthropathy can be reversed by normalizing GH and IGF-I levels only at the initial stage. If the disease is left untreated for long time, the osteo-articular sequelae cannot be modified by any treatment of acromegaly. PMID:16323826

  7. The sesamoid index in psoriatic arthropathy

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    Whitehouse, Richard W.; Aslam, Rizwan [Manchester Royal Infirmary, Department of Clinical Radiology, Manchester (United Kingdom); Bukhari, Marwan [Manchester Royal Infirmary, Department of Rheumatology, Manchester (United Kingdom); Groves, Clare; Cassar-Pullicino, Victor [Agnes Hunt and Robert Jones Hospital, Department of Radiology, Oswestry (United Kingdom)

    2005-04-01

    The sesamoid index was originally described as an aid to the diagnosis of acromegaly. We performed this study to assess the value of the thumb sesamoid index in the diagnosis of psoriatic arthropathy. Retrospective measurement of the sesamoid index (length x width of the medial thumb sesamoid), along with the age and sex were recorded for patients as described below. Patients with psoriasis were subdivided into those with or without radiographic evidence of hand arthropathy. Fifty-nine consecutive patients attending rheumatology clinics with arthralgia and psoriasis were studied. Comparison groups with radiographic evidence of rheumatoid arthritis (52 patients), osteoarthritis (44) or normal hands (55) were also recorded. Twenty-one of 59 patients with psoriasis and arthropathy had a sesamoid index >40, compared with two of 52 with rheumatoid arthritis, none of 44 with osteoarthritis and none of 55 normals. Psoriatic arthropathy is a recognised cause of bone enlargement, usually in the phalanges due to periostitis and proliferative enthesopathy. We have confirmed that psoriatic hand arthropathy can cause significant enlargement of the thumb sesamoids, a feature which is easily quantified and may assist diagnosis. (orig.)

  8. Optimal management of hemophilic arthropathy and hematomas

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    Lobet S

    2014-10-01

    Full Text Available Sébastien Lobet,1,2 Cedric Hermans,1 Catherine Lambert1 1Hemostasis-Thrombosis Unit, Division of Hematology, 2Division of Physical Medicine and Rehabilitation, Cliniques Universitaires Saint-Luc, Brussels, Belgium Abstract: Hemophilia is a hematological disorder characterized by a partial or complete deficiency of clotting factor VIII or IX. Its bleeding complications primarily affect the musculoskeletal system. Hemarthrosis is a major hemophilia-related complication, responsible for a particularly debilitating chronic arthropathy, in the long term. In addition to clotting factor concentrates, usually prescribed by the hematologist, managing acute hemarthrosis and chronic arthropathy requires a close collaboration between the orthopedic surgeon and physiotherapist. This collaboration, comprising a coagulation and musculoskeletal specialist, is key to effectively preventing hemarthrosis, managing acute joint bleeding episodes, assessing joint function, and actively treating chronic arthropathy. This paper reviews, from a practical point of view, the pathophysiology, clinical manifestations, and treatment of hemarthrosis and chronic hemophilia-induced arthropathy for hematologists, orthopedic surgeons, and physiotherapists. Keywords: hemophilia, arthropathy, hemarthrosis, hematoma, physiotherapy, target joint

  9. Advances and challenges in hemophilic arthropathy.

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    Wyseure, Tine; Mosnier, Laurent O; von Drygalski, Annette

    2016-01-01

    Hemophilic arthropathy is a form of joint disease that develops secondary to joint bleeding and presents with synovial hypertrophy, cartilage and bony destruction. The arthropathy can develop despite clotting factor replacement and is especially disabling in the aging population. Pathobiological tissue changes are triggered by release of hemoglobin and iron deposition in the joint, but the sequence of events and the molecular mechanisms resulting in joint deterioration are incompletely understood. Treatment options other than clotting factor replacement are limited. Improvements in the treatment of hemophilia necessitate a better understanding of the processes that lead to this disabling condition and better diagnostic tools. Towards that end, studies of the molecular mechanisms leading to the arthropathy, as well as the development of sensitive imaging techniques and biomarkers are needed. These will pave the way to identify the cause of acute pain such as joint bleeding or synovitis, detect early, potentially reversible structural changes, and predict progression of disease. This review describes current imaging techniques and the development of high resolution musculoskeletal ultrasound with power Doppler to afford point-of-care diagnosis and management, the potential utility of diagnostic biomarkers, and summarizes our current knowledge of the pathobiology of hemophilic arthropathy. PMID:26805902

  10. The radiological residua of healed diabetic arthropathies

    International Nuclear Information System (INIS)

    Diabetic arthropathy is a relatively rare manifestation of neuropathic disease, occurring in fewer than 5% of cases. Abnormalities of this type are confined largely to the small joints of the feet, although the larger joints of the lower limbs and the spine occasionally are affected. Some lesions, particularly in the feet, repair spontaneously, leaving radiological residua sufficiently characteristic to prompt suspicion of an unrecognised diabetic state. These include deformity of the head of the second metatarsal (akin to a Freiberg lesion), shortening of the great toe, painless deforming arthrosis of the knee, and ankylosis of interphalangeal joints. In the presence of these signs the patient should be interrogated concerning diabetes and blood sugar estimates, with provocation if necessary, obtained. Should such a diagnosis be sustained, appropriate protective measures may be undertaken to avoid a relapse of the arthropathy. (orig.)

  11. Imaging and staging of haemophilic arthropathy

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    Jelbert, A.; Vaidya, S. [Radiology Department, Barts and The London NHS trust, London (United Kingdom); Fotiadis, N., E-mail: nicos.fotiadis@bartsandthelondon.nhs.u [Radiology Department, Barts and The London NHS trust, London (United Kingdom)

    2009-11-15

    Arthropathy is one of the most disabling consequences of haemophilia. The management of this condition has been revolutionized by the introduction of prophylactic treatment with clotting factor replacements. In order for benefits of this treatment to be monitored, the severity of any joint disease needs to be accurately assessed. Diagnostic imaging is used to objectively evaluate haemophilic arthropathy (HA). There are several established scoring systems for grading HA based on conventional radiography and magnetic resonance imaging (MRI). In this review the role of the different imaging methods in the evaluation of HA are discussed, the established staging systems are presented, and an explanation of why MRI is becoming the primary method of joint imaging in HA is provided.

  12. A clinical study of psoriatic arthropathy

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    Prasad PVS

    2007-01-01

    Full Text Available Background: The incidence of uncomplicated psoriasis is 1-3% in the general population. Arthritis is found in increased frequency in psoriatic patients and its incidence is estimated to be 5-7%. Aim: To assess the prevalence of arthritis in psoriatic patients. Methods: Four hundred and seventy-two psoriatic patients were enrolled in the study out of which 40 patients had (psoriatic arthropathy (PsA. Severity of psoriasis was assessed by the psoriasis area and severity index (PASI. Routine blood investigations were carried out along with radiological investigations. Results: Forty percent of the 40 PsA patients were in the age group of 51-60 years. Seven patients out of the 40 (17.5% psoriatic arthropathic (PsA patients had a family history of psoriasis. Nail involvement was observed in 37 cases (92.5%. Rheumatoid factor was present in five out of the 40 (12.5% PsA patients. Serum uric acid levels were above normal in eighteen out of the 40 (45% PsA patients. Asymmetric oligoarthropathy was the most commonly observed feature in 42.5% of the 40 PsA patients. Narrowing of joint spaces and erosions were observed in 62.5% and 45% of the 40 PsA patients. Conclusion: There is an association between the duration of skin lesions and duration of arthropathy. Similarly the PASI score is also directly related with arthropathy.

  13. Magnetic resonance imaging of hemochromatosis arthropathy

    International Nuclear Information System (INIS)

    This study was undertaken to compare plain film radiography and magnetic resonance imaging in the assessment of hemochromatosis arthropathy of the knees of ten patients with a biopsy-proven diagnosis. Both modalities enabled visualisation of bony degenerative changes; magnetic resonance imaging enabled additional visualization of deformity of both cartilage and menisci. Magnetic resonance imaging failed reliably to confirm the presence of intra-articular iron in the patients studied. No correlation was observed between synovial fluid magnetic resonance signal values, corresponding serum ferritin levels, or the severity of the observed degenerative changes. (orig.)

  14. Magnetic resonance imaging of hemochromatosis arthropathy

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    Eustace, S. [Dept. of Radiology, Deaconess Hospital and Harvard Medical School, Boston, MA (United States); Buff, B. [Dept. of Radiology, Deaconess Hospital and Harvard Medical School, Boston, MA (United States); McCarthy, C. [The Inst. of Radiological Sciences, Mater Hospital, Dublin (Ireland); MacMathuana, P. [The Inst. of Radiological Sciences, Mater Hospital, Dublin (Ireland); Gilligan, P. [The Inst. of Radiological Sciences, Mater Hospital, Dublin (Ireland); Ennis, J.T. [The Inst. of Radiological Sciences, Mater Hospital, Dublin (Ireland)

    1994-10-01

    This study was undertaken to compare plain film radiography and magnetic resonance imaging in the assessment of hemochromatosis arthropathy of the knees of ten patients with a biopsy-proven diagnosis. Both modalities enabled visualisation of bony degenerative changes; magnetic resonance imaging enabled additional visualization of deformity of both cartilage and menisci. Magnetic resonance imaging failed reliably to confirm the presence of intra-articular iron in the patients studied. No correlation was observed between synovial fluid magnetic resonance signal values, corresponding serum ferritin levels, or the severity of the observed degenerative changes. (orig.)

  15. Neurogenic tumors of the stomach

    International Nuclear Information System (INIS)

    The general and radiologic features of neurogenic tumors of the stomach are reviewed in connection with 18 cases (16 benign and 2 maglignant tumors). Such neurogenic tumors are rare in the stomach, representing less than 0.5% of all tumors. Solitary neurogenic tumors must be differentiated from those encountered during von Recklinghausen's disease. Radiological or endoscopic examination can generally determine the benign or malignant nature of solitary neurogenic tumors, which are essentially represented by schwannomas. Since these tumors are submucosal, a deep biopsy is imperative; furthermore, since such tumors are subject to hemorrhage, prior investigation by CT appears advisable to detect possible hypervascularization after injection of contrast material. For patients with von Recklinghausen's disease, a neurofibroma is usually diagnosed when faced with a digestive hemorrhage. Radiological exploration of the entire digestive tract appears essential to confirm the solitary nature of the gastric lesion and to be sure it is responsible for the clinical symptoms. (orig.)

  16. Progression of haemophilic arthropathy in children

    DEFF Research Database (Denmark)

    Saulyte Trakymiene, S; Clausen, N; Poulsen, L H;

    2013-01-01

    childhood and adolescence, therefore joint abnormalities may be minimal on physical examination in very young children – even those receiving on-demand treatment. The aim of our study was to quantify the burden of arthropathy in Lithuanian patients who had been treated exclusively by on-demand substitution...... and compare their physical joint health with age-matched Danish patients who received prophylaxis from an early age. Boys, aged 4–17 years, with severe haemophilia and no signs of inhibitors were included in the study. Joint outcome based on the Haemophilia Joint Health Score (HJHS) was analysed in....... Significance of the difference in joint status comparing different treatment strategies was equally strong both in younger (4–9 years) and older (10–17 years) patient groups: 2.2 vs. 12.5 (P = 0.0002) and 3.9 vs. 36.3 (P < 0.0001) respectively. The results further demonstrate the unequivocal effect of...

  17. Cough responsiveness in neurogenic dysphagia

    OpenAIRE

    SMITH, P.; Wiles, C

    1998-01-01

    OBJECTIVES—In neurogenic dysphagia a good cough is important for airway protection. If triggering of cough, or its effectiveness, is impaired this might result in an increased aspiration risk. Capsaicin, an agent which induces cough through sensory nerve stimulation, was used to test cough sensitivity in groups of patients with and without neurogenic dysphagia.
METHODS—On the basis of swallowing speed (ml/s) in a validated water test 28 alert neurological inpatients (16 wome...

  18. Sarcopenia, a Neurogenic Syndrome?

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    Ping Kwan

    2013-01-01

    Full Text Available Sarcopenia is an aging-associated condition, which is currently characterized by the loss of muscle mass and muscle strength. However, there is no consensus regarding its characterization hitherto. As the world older adult population is on the rise, the impact of sarcopenia becomes greater. Due to the lack of effective treatments, sarcopenia is still a persisting problem among the global older adults and should not be overlooked. As a result, it is vital to investigate deeper into the mechanism underlying the pathogenesis of sarcopenia in order to develop more effective therapeutic interventions and to inscribe a more uniform characterization. The etiology of sarcopenia is currently found to be multifactorial, and most of the pharmacological researches are focused on the muscular factors in aging. Although the complete mechanism underlying the development of sarcopenia is still waiting to be elucidated, we propose in this article that the primary trigger of sarcopenia may be neurogenic in origin based on the intimate relationship between the nervous and muscular system, namely, the motor neuron and its underlying muscle fibers. Both of them are affected by the cellular environment and their physiological activity.

  19. Neurogenic and non neurogenic functions of endogenous neural stem cells.

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    Erica eButti

    2014-04-01

    Full Text Available Adult neurogenesis is a lifelong process that occurs in two main neurogenic niches of the brain, namely in the subventricular zone (SVZ of the lateral ventricles and in the subgranular zone (SGZ of the dentate gyrus (DG in the hippocampus. In the 1960s, studies on adult neurogenesis have been hampered by the lack of established phenotypic markers. The precise tracing of neural stem/progenitor cells (NPCs was therefore, not properly feasible. After the (partial identification of those markers, it was the lack of specific tools that hindered a proper experimental elimination and tracing of those cells to demonstrate their terminal fate and commitment. Nowadays, irradia-tion, cytotoxic drugs as well as genetic tracing/ablation procedures have moved the field forward and increased our understanding of neurogenesis processes in both physiological and pathological conditions. Newly formed NPC progeny from the SVZ can replace granule cells in the olfactory bulbs of rodents, thus contributing to orchestrate sophisticated odour behaviour. SGZ-derived new granule cells, instead, integrate within the DG where they play an essential role in memory functions. Furthermore, converging evidence claim that endogenous NPCs not only exert neurogenic functions, but might also have non-neurogenic homeostatic functions by the release of different types of neuroprotective molecules. Remarkably, these non-neurogenic homeostatic functions seem to be necessary, both in healthy and diseased conditions, for example for preventing or limiting tissue damage. In this review, we will discuss the neurogenic and the non-neurogenic functions of adult NPCs both in physiological and pathological conditions.

  20. Ochronotic arthropathy: structural and ultrastructural features.

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    Melis, M; Onori, P; Aliberti, G; Vecci, E; Gaudio, E

    1994-01-01

    Fragments of articular cartilage and synovial membrane in a case of ochronosis were studied by light microscopy (LM), polarized light, and transmission electron microscopy (TEM). Granular and/or shard-shaped pigments were observed in the synovia, cartilage, and subchondral tissue, and dispersed pigment was also seen in the synovial fluid. Zones of the articular cartilage surface showed small erosions near shards, and sometimes, when the degenerative process was in an advanced stage, a substitutive fibrosis of the cartilage edge was demonstrated. LM and TEM observations of the samples studied revealed an alteration of collagen fibrils that appeared wavy and sometimes fragmented with loss of periodicity. They were always mixed with the dispersed pigment. A peculiar finding that characterized this ochronotic case was the complete absence of inflammatory infiltrates or signs of monocyte-macrophage activation. These structural and ultrastructural observations suggest that the pigment deposition in the articular surfaces was due to the synovial fluid circulation and partially to subchondral blood flow, which transports and stores the ochronotic pigments in the synovia and cartilage. These etiopathologic elements associated with the mechanical pathogenesis naturally present in the joints can contribute to the explanation of the pathogenesis and origin of ochronotic arthropathy. PMID:7809996

  1. Neurogenic inflammation in human and rodent skin

    DEFF Research Database (Denmark)

    Schmelz, M; Petersen, Lars Jelstrup

    2001-01-01

    The combination of vasodilation and protein extravasation following activation of nociceptors has been termed "neurogenic inflammation." In contrast to rodents, no neurogenic protein extravasation can be elicited in healthy human skin. Dermal microdialysis has considerably increased our knowledge...... about neurogenic inflammation in human skin, including the involvement of mast cells....

  2. Inflammatory myofibroblastic tumor in lung with osteopulmonary arthropathy

    Institute of Scientific and Technical Information of China (English)

    ZHANG Yi; DONG Zong-jun; ZHI Xiu-yi; LIU Lei; HU Mu

    2009-01-01

    @@ Inflammatory myofibroblastic tumor (IMT) is a rare disease that usually occurs in the lung. Recently, several reports have suggested that IMT is a true neoplasm rather than a reactive lesion. By definition, it is composed of spindle cells (myofibroblasts) with variable inflammatory component, hence the name is IMT. We report a patient of inflammatory myofibroblastic tumor in lung with osteopulmonary arthropathy.

  3. Computer-navigated total knee arthroplasty in haemophilic arthropathy.

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    Cho, K-Y; Kim, K-I; Khurana, S; Cho, S-W; Kang, D-G

    2013-03-01

    Total knee arthroplasty (TKA) in end-stage haemophilic arthropathy is complex and challenging due to the altered bony anatomy, arthrofibrosis and muscle contractures. Computer navigation is especially advocated in patients with deformity or altered anatomy to improve alignment and to assist in ligament balancing. The objective of this study was to evaluate the results of computer-navigated TKA in haemophilic arthropathy. A consecutive series of computer-assisted TKA for the end-stage haemophilic arthropathy between February 2007 and December 2009 were evaluated. A total of 27 TKA were performed in 25 patients. Pre- and postoperative full-length weight-bearing radiographs were assessed for the axial limb alignment. The orientation of the components was measured on anteroposterior radiographs. Clinically, Knee Society score and Short Form-36 were evaluated. The mechanical axis of the leg was within a range of ±3° varus/valgus in 92% of the TKA. The coronal alignment of the femoral and tibial components was within a range of ±3 degrees in 96% of the knees. The clinical outcomes were significantly improved after the operation. There were no complications specific to the computer navigation. Computer-navigated TKA helps in restoring the mechanical axis and improves accuracy of orientation of the components in patients with end-stage haemophilic arthropathy. Potential benefits in long-term outcome require further investigation. PMID:23171356

  4. Digital scoring of haemophilic arthropathy using radiographs is feasible

    NARCIS (Netherlands)

    Jansen, N. W. D.; Vincken, K. L.; Marijnissen, A. C. A.; Lundin, B.; Heijnen, L.; Roosendaal, G.; Pettersson, H.; Lafeber, F. P. J. G.

    2008-01-01

    Radiographs are important tools to evaluate structural changes in many Joint diseases. In the case of haemophilic arthropathy (HA), the Pettersson score is widely used. The rising of digital radiography enables evaluation of these changes in a more quantitative and detailed manner, potentially impro

  5. The development of epiphyses in haemophiliac arthropathy of the elbow

    International Nuclear Information System (INIS)

    Destructive and reparative changes in haemophiliac arthropathy can be observed particularly well in the elbow, since bleeding occures usually in childhood during development of the epipyses. These appear prematurely as a result of florid heamophiliac changes. They are enlarged and their structure is altered. Stress areas show typical impression deformations and in other areas the bone becomes expanded. Extensive deformities are irreversible and usually lead to severe functional impairment. It is, however, of therapeutic importance to evaluate these changes radiologically. The literature contains various special features of heamophiliac arthropathy of the elbow. As early as 1897, two years after the discovery of X-rays, Shaw described enlargement of the head of the radius. Increased depth of the groove of the trochlea, of the incisura radialis ulnae and of the olecranon fossa are regarded as typical. Deformities of the tip of the olecranon and of the coronoid process are also described (De Palma 1956, Jordan 1958, Ahlberg 1965, Weseloh 1973). At the rehabilitation centre for children and adolescents at Neckargemuend, 100 heamophiliacs have been examined systematically. Development of the arthropathy has been followed for a period of five years. Three typical heamophiliac arthropathies of the elbow are described and discussed. Classification is proposed according to a system published in 1980. (orig.)

  6. Radiation synovectomy - Role in management of hemophiliac arthropathy

    International Nuclear Information System (INIS)

    Full text: Joint disorders are the major cause of disabilities. It is a threat to a person's social, economical, physical and psychological health. Besides infectious and degenerative arthritic disorders, hemophiliac arthropathy cause major role in crippling young individuals and needs special attention. Hemophilia is a common clotting disorder due to factor VIII (Hemophilia A) and IX (Hemophilia B) deficiency. More than 50% of these patients suffer from chronic hemophilic arthropathy. The incidence of hemophiliac arthropathy is increasing in Pakistan due to lack of facilities of factor VIII replacement and its high cost for long-term treatment. Different treatment options like chemical synovectomy and surgical removal of synovium are available to treat these patients. Due to high morbidity of surgical procedures and severe pain during chemical synovectomy, we started radiation synovectomy in our center. In this study we have evaluated the role of radiation synovectomy using Re-188 Tin colloid and P-32 colloid in hemophiliac children with grades I and II arthropathy. Intraarticular injection was administered to large joints of lower and upper limbs under strict aseptic conditions. Immediate and delayed static images were acquired to evaluate the leakage to regional lymph nodes. Response to treatment was assessed on follow up with respect to improvement in pain, joint swelling, range of movement, number of episodes of subsequent haemarthrosis and amount of factor VII requirements. In conclusion, radiation synovectomy proved to be effective; it improved the range of motion and is better tolerated by patients due to less pain during the post- therapy period. Significant reduction in factor VIII replacement improved the management of haemophiliac arthropathy and results proved the cost effectiveness of radiation synovectomy. (author)

  7. Arthropathie destructrice des epaules au cours d�une acromegalie

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    Nessrine Akasbi

    2011-10-01

    Full Text Available L�acromegalie est une maladie endocrinienne rare, en rapport avec une hypersecretion d�hormone de croissance. Elle a des consequences rhumatologiques: l�arthropathie peripherique, l�atteinte rachidienne et les syndromes canalaires. L�atteinte articulaire accompagne une acromegalie active, sa survenue apres un traitement radical et une remission complete est rare. Nous presentons le cas d�une patiente de 70 ans ayant un antecedent d�acromegalie sur adenome hypophysaire il y a 25 ans, traitee chirurgicalement et declaree en remission complete, a developpe une arthropathie destructrice des deux epaules. Le but de notre observation est de mettre le point sur la possibilite d�une atteinte articulaire au cours de l�acromegalie et de son retentissement fonctionnelle.

  8. Neuropathic arthropathy (Charcot's joint) in dialysis patients

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    Meneghello, A.; Bertoli, M.

    1984-08-01

    To the author's knowledge, uraemic neuropathy has not been previously reported as a cause of Charcot's joint. In this paper they present three cases in which the association between clinical and radiographic patterns suggest the diagnosis of neuropathic arthropathy. The features of uraemic neuropathy are stressed and the role of secondary hyperparathyroidism in the development of this type of arthropathy is discussed. The extremely severe hyperparathyroidism reported here, may cause tendon and ligament disease, especially at the site of their bone insertion. Uraemic tendon and ligament failures weaken joints and produce further instability, which may be a precipitating factor of uraemic Charcot's joint in patients undergoing chronic haemodialysis. 5 figs.

  9. Deferiprone-induced arthropathy in thalassemia: MRI findings in a case

    International Nuclear Information System (INIS)

    Arthropathy is a well known side effect of the iron chelator deferiprone (L1); however, the imaging findings in deferiprone-induced arthropathy are not well known. In this article, we describe the typical radiographic and MRI findings in a patient receiving regular blood transfusions who developed arthropathy after long-term therapy with the oral iron chelator deferiprone (L1). Deferiprone primarily affects the articular cartilage and the changes include synovial thickening, articular cartilage thickening, and subchondral bone erosions

  10. Understanding migraine: Potential role of neurogenic inflammation

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    Rakesh Malhotra

    2016-01-01

    Full Text Available Neurogenic inflammation, a well-defined pathophysiologial process is characterized by the release of potent vasoactive neuropeptides, predominantly calcitonin gene-related peptide (CGRP, substance P (SP, and neurokinin A from activated peripheral nociceptive sensory nerve terminals (usually C and A delta-fibers. These peptides lead to a cascade of inflammatory tissue responses including arteriolar vasodilation, plasma protein extravasation, and degranulation of mast cells in their peripheral target tissue. Neurogenic inflammatory processes have long been implicated as a possible mechanism involved in the pathophysiology of various human diseases of the nervous system, respiratory system, gastrointestinal tract, urogenital tract, and skin. The recent development of several innovative experimental migraine models has provided evidence suggestive of the involvement of neuropeptides (SP, neurokinin A, and CGRP in migraine headache. Antidromic stimulation of nociceptive fibers of the trigeminal nerve resulted in a neurogenic inflammatory response with marked increase in plasma protein extravasation from dural blood vessels by the release of various sensory neuropeptides. Several clinically effective abortive antimigraine medications, such as ergots and triptans, have been shown to attenuate the release of neuropeptide and neurogenic plasma protein extravasation. These findings provide support for the validity of using animal models to investigate mechanisms of neurogenic inflammation in migraine. These also further strengthen the notion of migraine being a neuroinflammatory disease. In the clinical context, there is a paucity of knowledge and awareness among physicians regarding the role of neurogenic inflammation in migraine. Improved understanding of the molecular biology, pharmacology, and pathophysiology of neurogenic inflammation may provide the practitioner the context-specific feedback to identify the novel and most effective therapeutic

  11. Understanding migraine: Potential role of neurogenic inflammation.

    Science.gov (United States)

    Malhotra, Rakesh

    2016-01-01

    Neurogenic inflammation, a well-defined pathophysiologial process is characterized by the release of potent vasoactive neuropeptides, predominantly calcitonin gene-related peptide (CGRP), substance P (SP), and neurokinin A from activated peripheral nociceptive sensory nerve terminals (usually C and A delta-fibers). These peptides lead to a cascade of inflammatory tissue responses including arteriolar vasodilation, plasma protein extravasation, and degranulation of mast cells in their peripheral target tissue. Neurogenic inflammatory processes have long been implicated as a possible mechanism involved in the pathophysiology of various human diseases of the nervous system, respiratory system, gastrointestinal tract, urogenital tract, and skin. The recent development of several innovative experimental migraine models has provided evidence suggestive of the involvement of neuropeptides (SP, neurokinin A, and CGRP) in migraine headache. Antidromic stimulation of nociceptive fibers of the trigeminal nerve resulted in a neurogenic inflammatory response with marked increase in plasma protein extravasation from dural blood vessels by the release of various sensory neuropeptides. Several clinically effective abortive antimigraine medications, such as ergots and triptans, have been shown to attenuate the release of neuropeptide and neurogenic plasma protein extravasation. These findings provide support for the validity of using animal models to investigate mechanisms of neurogenic inflammation in migraine. These also further strengthen the notion of migraine being a neuroinflammatory disease. In the clinical context, there is a paucity of knowledge and awareness among physicians regarding the role of neurogenic inflammation in migraine. Improved understanding of the molecular biology, pharmacology, and pathophysiology of neurogenic inflammation may provide the practitioner the context-specific feedback to identify the novel and most effective therapeutic approach to treatment

  12. Central Neurogenic Respiratory Failure: A Challenging Diagnosis

    OpenAIRE

    Carvalho, Flávio A.; Bernardino, Tenille; Maciel, Ricardo O.H.; Felizola, Sérgio F.A.; Costa, Eduardo L.V.; Silva, Gisele S

    2011-01-01

    Background Central nervous system lesions are rare causes of respiratory failure. Simple observation of the breathing pattern can help localize the lesion, but the examiner needs to be aware of potential pitfalls such as metabolic or pulmonary alterations. Methods We describe 3 cases in which central neurogenic respiratory failure occurred simultaneously with other alterations or in an unusual presentation. Results All patients were diagnosed with central neurogenic respiratory failure and tr...

  13. The role of histamine in neurogenic inflammation

    OpenAIRE

    Rosa, A. C.; Fantozzi, R

    2013-01-01

    The term ‘neurogenic inflammation’ has been adopted to describe the local release of inflammatory mediators, such as substance P and calcitonin gene-related peptide, from neurons. Once released, these neuropeptides induce the release of histamine from adjacent mast cells. In turn, histamine evokes the release of substance P and calcitonin gene-related peptide; thus, a bidirectional link between histamine and neuropeptides in neurogenic inflammation is established. The aim of this review is to...

  14. The effect of radiation therapy on hemophilic arthropathy

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Jin Oh; Hong, Seong Eon; Kim, Sang Gi; Shin, Dong Oh [School of Medicine, KyungHee University, Seoul (Korea, Republic of)

    2005-06-15

    Repetitive bleeding into the joint space is the cause of debilitative hemophilic arthropathy. To interrupt this process, we treated the hemophilic patients suffering from repetitive joint bleeding with radiation therapy. From 1997 to 2001, a total of 41 joints from 37 hemophilic arthropathy patients were treated with radiation therapy at KyungHee University Hospital. The treated joints were 35 ankles, 3 knees and 3 elbows, respectively. The age of the patients ranged from 4 to 27 years (median age: 11 years). The radiation dose ranged from 900 cGy to 2360 cGy (median dose: 900 cGy). The fraction size was 150 cGy, 180 cGy or 200 cGy. The number of bleeding in one year before and after radiotherapy was compared. There was a tendency of frequent bleeding for the patients younger than 11 ({rho} 0.051) but there was also a tendency for more improvement in this group ({rho} 0.057). The number of joint bleedings was related with joint pain ({rho} 0.012) and joint swelling ({rho} = 0.033) but not with the Arbold-Hilgartner stage ({rho} 0.739),cartilage destruction ({rho} = 0.718) and synovial hypertrophy ({rho} = 0.079). The number of bleeding was reduced in thirty-three cases, and eight cases showed no improvement after radiation therapy. The average number of bleeding in a month was 2.52 before radiotherapy, but this was reduced to 1.4 after radiotherapy ({rho} = 0.017). Radiation therapy was effective for the hemophilia patients with repetitive joint bleeding to decrease the bleeding frequency and to prevent hemophilic arthropathy.

  15. MR imaging of arthropathies of juvenile arthritis and hemophilia

    International Nuclear Information System (INIS)

    The arthropathies of juvenile arthritis and hemophilia have in common abnormal hyperplastic synovium leading to marginal bone erosion, articular cartilage destruction, subchondral bone exposure, and dissolution and ultimately collapse of the affected joint. The authors examined children and young adults with juvenile arthritis and hemophilia by MR imaging and found that they could identify hyperplastic synovium, articular cartilage lesions, bone erosions, and joint effusions. This has therapeutic implications since identification of progressive synovial hyperplasia and/or early cartilage or marginal bone erosion may lead to earlier synovectomy in patients with hemophilia or switch to second line drugs in patients with juvenile arthritis, in an attempt to prevent progressive joint destruction

  16. The impact of HSV for inflammatory arthropathy patients.

    LENUS (Irish Health Repository)

    O'Connor, Mortimer B

    2012-02-01

    Herpes simplex virus type 1 (HSV-1), also known as herpes labialis, is the etiologic agent of vesicular lesions of the oral mucosa commonly referred to as "cold sores". HSV-1 can also cause clinical disease in a wide variety of other anatomic locations including the genitalia, liver, lung, eye, and central nervous system. These infections can be severe, particularly in the setting of immunosuppression, such as inflammatory arthropathy patients on Methotrexate ± biological therapies. Here, we highlight the importance of physician awareness of HSV due to its potential impact for rheumatology patients.

  17. Neurogenic vascular headaches, food and chemical triggers.

    Science.gov (United States)

    Trotsky, M B

    1994-04-01

    Recent evidence has demonstrated that neurogenic vascular headaches are a combination of neurological primary events and secondary vasomotor changes. The neurological events involve the hypothalamus and sensory cortex with sympathetic hypofunction and noradrenergic abnormalities. A platelet theory has been proposed but has not really been confirmed as a legitimate cause of the neurogenic vascular headaches. Food and chemicals in foods can act as a precipitating factor in the food-sensitive neurogenic vascular headache patient. In these patients evidence is now being demonstrated to confirm this, but larger patient studies are needed. The food-sensitive migraine patient and cluster headache patient must give a good history and food diary to go along with active challenges and provocative testing in order to determine the causative foods. Any concomitant allergies of inhalants or environmentals must also be treated. The treatment modalities of elimination and rotation diets or provocation neutralization may successfully control the headaches without the need for continuous medications.

  18. Neurogenic muscle hypertrophy: a case report

    Science.gov (United States)

    Shin, Hyun Ho; Jeon, Young Hoon; Jang, Seung Won

    2016-01-01

    Muscular hypertrophy is caused mainly due to myopathic disorder. But, it is also rarely produced by neurogenic disorder. A 74-year-old woman complained of right calf pain with hypertrophy for several years. Recent lumbar spine magnetic resonance imaging (MRI) showed central and lateral canal narrowing at the L4-L5 intervertebral space. Lower extremity MRI revealed fatty change of right medial head of the gastrocnemius and soleus, causing right calf hypertrophy. Electrodiagnostic examinations including electromyography and nerve conduction velocity testing demonstrated 5th lumbar and 1st sacral polyradiculopathy. Integrating all the results, the diagnosis was neurogenic muscle hypertrophy. Neurogenic muscle hypertrophy is very rare, but we recommend that clinicians consider this problem when a patient complains of lower limb hypertrophy and pain.

  19. Hip arthropathy in a patient with primary hemochromatosis: MR imaging findings with pathologic correlation

    Energy Technology Data Exchange (ETDEWEB)

    Papakonstantinou, Olympia [Veterans Affairs Medical Center, University of California, Department of Radiology, San Diego (United States); University Hospital of Heraklion, Department of Radiology, Heraklion, Crete (Greece); Mohana-Borges, Aurea V.R.; Campell, Loretta; Trudell, Debra; Resnick, Donald [Veterans Affairs Medical Center, University of California, Department of Radiology, San Diego (United States); Haghighi, Parviz [Veterans Affairs Medical Center, University of California, Department of Pathology, San Diego, California (United States)

    2005-03-01

    Arthropathy is a major clinical manifestation in primary hemochromatosis, typically affecting the metacarpophalangeal joints. Hip arthropathy is not uncommon, with radiologic features resembling osteoarthritis or calcium pyrophosphate dihydrate (CPPD) crystal deposition disease. We describe the MR imaging findings of the hip in a patient with severe hip arthropathy and primary hemochromatosis and correlate them with the histopathologic findings. MR imaging showed severe degenerative changes, with large subchondral cysts and subchondral sclerosis in the femoral head and acetabulum. There was conspicuous correlation between MR imaging and pathologic findings of the resected femoral head. However, MR imaging failed to reveal intra-articular iron. (orig.)

  20. Deforming arthropathy in SLE: review in the literature apropos of one case.

    Science.gov (United States)

    Pipili, Chrisoula; Sfritzeri, Areti; Cholongitas, Evangelos

    2009-08-01

    Among the clinical manifestations of systemic lupus erythematosus is an arthropathy, which is usually non-erosive. In many cases, the joint involvement is mild. A subset of patients has deforming, non-erosive Jaccoud's arthropathy, and a minority have an arthropathy with clinical findings similar to rheumatoid arthritis that has been called "rhupus". We report a case of a 48-year-old female rhupus patient. The lack of clinical criteria for this rheumatic condition has created confusion in the characterization of this disorder. Thus, more effort is needed to establish a potential and clear definition for rhupus. PMID:19066900

  1. Hip arthropathy in a patient with primary hemochromatosis: MR imaging findings with pathologic correlation.

    Science.gov (United States)

    Papakonstantinou, Olympia; Mohana-Borges, Aurea V R; Campell, Loretta; Trudell, Debra; Haghighi, Parviz; Resnick, Donald

    2005-03-01

    Arthropathy is a major clinical manifestation in primary hemochromatosis, typically affecting the metacarpophalangeal joints. Hip arthropathy is not uncommon, with radiologic features resembling osteoarthritis or calcium pyrophosphate dihydrate (CPPD) crystal deposition disease. We describe the MR imaging findings of the hip in a patient with severe hip arthropathy and primary hemochromatosis and correlate them with the histopathologic findings. MR imaging showed severe degenerative changes, with large subchondral cysts and subchondral sclerosis in the femoral head and acetabulum. There was conspicuous correlation between MR imaging and pathologic findings of the resected femoral head. However, MR imaging failed to reveal intra-articular iron. PMID:15316682

  2. Hip arthropathy in a patient with primary hemochromatosis: MR imaging findings with pathologic correlation

    International Nuclear Information System (INIS)

    Arthropathy is a major clinical manifestation in primary hemochromatosis, typically affecting the metacarpophalangeal joints. Hip arthropathy is not uncommon, with radiologic features resembling osteoarthritis or calcium pyrophosphate dihydrate (CPPD) crystal deposition disease. We describe the MR imaging findings of the hip in a patient with severe hip arthropathy and primary hemochromatosis and correlate them with the histopathologic findings. MR imaging showed severe degenerative changes, with large subchondral cysts and subchondral sclerosis in the femoral head and acetabulum. There was conspicuous correlation between MR imaging and pathologic findings of the resected femoral head. However, MR imaging failed to reveal intra-articular iron. (orig.)

  3. Neurogenic Stuttering and Lateralized Motor Deficits Induced by Tranylcypromine

    Directory of Open Access Journals (Sweden)

    J. D. Duffy

    1994-01-01

    Full Text Available A case of neurogenic stuttering induced by the monoamine oxidase inhibitor tranylcypromine is described. The association of neurogenic stuttering with acquired lateralized motor deficits in the patient described is discussed with reference to current theories regarding the pathogenesis of neurogenic stuttering.

  4. Assessment of Hemophilic Arthropathy by Ultrasound: Where Do We Stand?

    Science.gov (United States)

    Di Minno, Matteo Nicola Dario; Ambrosino, Pasquale; Quintavalle, Gabriele; Coppola, Antonio; Tagliaferri, Annarita; Martinoli, Carlo; Rivolta, Gianna Franca

    2016-07-01

    Joint hemorrhages represent the most common type of bleeding episode in persons with hemophilia, and recurrent hemarthrosis triggers chronic arthropathy, which is the most frequent chronic complication in these patients. In recent years, in the frame of a comprehensive care approach, a growing attention has been given to the periodic assessment of the joint status in hemophilia patients with the aim to identify early arthropathic changes and to prevent the development of a clinically overt arthropathy. Besides clinical examination, X-ray and magnetic resonance imaging (MRI) are currently used to evaluate joint status and to monitor the disease progression in hemophilia. Considering the limitations of X-ray and MRI, growing interest has been given to ultrasound (US) as a possible tool to assess joint status and identify early arthropathic changes in hemophilia patients. In the present review, we summarize major literature evidence on the use of joint US for the evaluation of markers of disease activity (joint effusion and synovial hypertrophy) and of degenerative damages (osteochondral changes) in patients with hemophilia. On the whole, being able to identify the presence of intra- or extra-articular fluid, US examination is the fastest and most reliable technique to identify acute conditions, such as hemarthrosis. In addition, the information on joint involvement provided by US in the patient follow-up may influence treatment decisions on a personalized basis. The use of US as part of a routine clinical examination by hemophilia experts may optimize the diagnostic workflow, avoiding additional costs and long waiting lists for patients referred to imaging departments. In the frame of a comprehensive care approach, US might represent a strategy to early detect and monitor synovial hypertrophy and osteochondral changes in hemophilia, thus extending the clinical examination and helping identify joints to be studied with a second-level examination such as MRI. PMID

  5. Repeated autologous intraarticular blood injections as an animal model for joint pain in haemophilic arthropathy

    OpenAIRE

    Boettger, Michael Karl; Krucker, Susanne; Gajda, Mieczyslaw; Schaible, Hans-Georg; Hilberg, Thomas

    2013-01-01

    Introduction Haemophilic arthropathy following recurrent joint bleedings is one of the major disease-related complications in people with haemophilia (PWH), leading to mostly chronic joint pain. Since many antinociceptive principles interfere with the clotting system, PWH are restricted in treatment options, thereby defining a medical need for novel therapeutic principles. However, we lack the availability of an animal model for joint pain in haemophilic arthropathy for testing these. Methods...

  6. Neuropathic arthropathy of the shoulder interpreted as neoplasic lesion (reports of two cases)

    International Nuclear Information System (INIS)

    The neuropathic arthropathy is an illness that destroys the articulation, associated to loss of the propiocepcion. Inside the main causes they are the syringomyelia, tertiary syphilis and diabetes mellitus. In the superior member the frequently affected articulation is the glen humeral. In this report two patients are presented with neuropathic arthropathy from the shoulder secondary to syringomyelia and remitted to orthopedic oncology with diagnosis of condrosarcoma. The clinical radiological presentation and the differential diagnosis are analyzed

  7. Charcot arthropathy in ultrasound examination - a case report.

    Science.gov (United States)

    Płaza, Mateusz; Nowakowska-Płaza, Anna; Walentowska-Janowicz, Marta; Chojnowski, Marek; Sudoł-Szopińska, Iwona

    2016-06-01

    This article presents a patient with a long history of type 1 diabetes mellitus complicated with neuropathy and Charcot disease. The most common cause of neuropathic osteoarthropathy, called Charcot osteoarthropathy, is poorly controlled diabetes. The clinical picture is characterized by considerable edema, redness and increased skin temperature with relatively slight pain due to injury to nerve fibers responsible for pain sensation. The differential diagnosis should include bacterial or autoimmune arthritis, arthritis associated with gout as well as venous thrombosis and injury. The contribution of a local inflammatory reaction and abnormal bone turnover with excessive osteoclast activity might play a role in the etiopathogenesis of this disease. As a result, osseous and articular destruction progresses rapidly leading to irreversible deformity of the foot. Avoiding weight-bearing and resting the foot in a specially selected plaster cast is the most important part of treatment. Patients with the aforementioned complaints are referred to radiologists for imaging examinations. An ultrasonographer should pay attention to changes typical of Charcot arthropathy, such as: inflammatory and destructive changes in joints of the foot, uneven contour of bones with thickening and periosteal hyperemia as well as soft tissue swelling.

  8. Microglia from neurogenic and non-neurogenic regions display differential proliferative potential and neuroblast support

    Directory of Open Access Journals (Sweden)

    Gregory Paul Marshall

    2014-07-01

    Full Text Available Microglia isolated from the neurogenic subependymal zone (SEZ and hippocampus (HC are capable of massive in vitro population expansion that is not possible with microglia isolated from non-neurogenic regions. We asked if this regional heterogeneity in microglial proliferative capacity is cell intrinsic, or is conferred by interaction with respective neurogenic or non-neurogenic niches. By combining SEZ and cerebral cortex (CTX primary tissue dissociates to generate heterospatial cultures, we find that exposure to the SEZ environment does not enhance CTX microglia expansion; however, the CTX environment exerts a suppressive effect on SEZ microglia expansion. Furthermore, addition of purified donor SEZ microglia to either CTX- or SEZ-derived cultures suppresses the expansion of host microglia, while the addition of donor CTX microglia enhances the over-all microglia yield. These data suggest that SEZ and CTX microglia possess intrinsic, spatially restricted characteristics that are independent of their in vitro environment, and that they represent unique and functionally distinct populations. Finally, we determined that the repeated supplementation of neurogenic SEZ cultures with expanded SEZ microglia allows for sustained levels of inducible neurogenesis, provided that the ratio of microglia to total cells remains within a fairly narrow range.

  9. Botulinum Toxin to Treat Neurogenic Bladder.

    Science.gov (United States)

    Smith, Christopher P; Chancellor, Michael B

    2016-02-01

    Alteration in neural control from suprapontine areas to the nerves innervating the bladder can lead to bladder dysfunction and the development of a neurogenic bladder (NGB). Patients with NGB often suffer from urinary incontinence, which can lead to adverse events such as urinary tract infections and decubiti, in addition to creating a large care burden for family members or healthcare providers and significantly impairing patient quality of life. The common failure of anticholinergic medications has spurned the development of second-line treatments, including the use of botulinum toxin. OnabotulinumtoxinA (onaBoNT-A; BOTOX, Allergan, Inc.) was approved by the U.S. Food and Drug Administration (FDA) in 2011 to treat neurogenic detrusor overactivity in patients with urinary incontinence resulting from a NGB. In this review the authors summarize pertinent results from key trials leading to FDA approval of onaBoNT-A as well as more recent long-term data.

  10. Understanding migraine: Potential role of neurogenic inflammation

    OpenAIRE

    Rakesh Malhotra

    2016-01-01

    Neurogenic inflammation, a well-defined pathophysiologial process is characterized by the release of potent vasoactive neuropeptides, predominantly calcitonin gene-related peptide (CGRP), substance P (SP), and neurokinin A from activated peripheral nociceptive sensory nerve terminals (usually C and A delta-fibers). These peptides lead to a cascade of inflammatory tissue responses including arteriolar vasodilation, plasma protein extravasation, and degranulation of mast cells in their peripher...

  11. Neurogenic Pulmonary Edema Developing After Cesarean Section

    OpenAIRE

    Güleç, Handan; Babayigit, Münire; Kurtay, Aysun; Tutal, Zehra; Dereli, Necla; Sahin, Saziye; Horasanli, Eyup

    2015-01-01

    Neurogenic pulmonary edema (NPE) is a pathogenesis of pulmonary edema which occurs often in the early period following the acute neurologic changes affecting the central nervous system and proceeds with respiratory failure. It causes respiratory problems requiring intubation in the patient. When evaluated in general terms, the pathophysiology of NPE includes cardiopulmonary dysfunction caused by catecholamines that are secreted rapidly and abundantly. This case study will examine the respirat...

  12. Neurogenic bladder in spinal cord injury patients

    Directory of Open Access Journals (Sweden)

    Al Taweel W

    2015-06-01

    Full Text Available Waleed Al Taweel, Raouf SeyamDepartment of Urology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi ArabiaAbstract: Neurogenic bladder dysfunction due to spinal cord injury poses a significant threat to the well-being of patients. Incontinence, renal impairment, urinary tract infection, stones, and poor quality of life are some complications of this condition. The majority of patients will require management to ensure low pressure reservoir function of the bladder, complete emptying, and dryness. Management typically begins with anticholinergic medications and clean intermittent catheterization. Patients who fail this treatment because of inefficacy or intolerability are candidates for a spectrum of more invasive procedures. Endoscopic managements to relieve the bladder outlet resistance include sphincterotomy, botulinum toxin injection, and stent insertion. In contrast, patients with incompetent sphincters are candidates for transobturator tape insertion, sling surgery, or artificial sphincter implantation. Coordinated bladder emptying is possible with neuromodulation in selected patients. Bladder augmentation, usually with an intestinal segment, and urinary diversion are the last resort. Tissue engineering is promising in experimental settings; however, its role in clinical bladder management is still evolving. In this review, we summarize the current literature pertaining to the pathology and management of neurogenic bladder dysfunction in patients with spinal cord injury.Keywords: neurogenic bladder, spinal cord injury, urodynamics, intestine, intermittent catheterization

  13. Preoperative neurogenic pulmonary edema: A dilemma for decision making

    OpenAIRE

    Siva Kumar Reddy Lakkireddigari; Padmaja Durga; Madhukar Nayak; Gopinath Ramchandran

    2012-01-01

    Neurogenic pulmonary edema may be a less-recognized consequence of obstructive hydrocephalus. The authors report a patient with acute obstructive hydrocephalus due to cerebellar metastatic lesion, who presented with neurogenic pulmonary edema. The edema resolved on placement of the ventriculoperitonial shunt. This report addresses the importance of recognition of neurogenic pulmonary edema as a possible perioperative complication resulting from an increase in intracranial pressure and the iss...

  14. Hemophilic arthropathy. A scoring system for magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Soler, R.; Rodriguez, E.; Marini, M. [Department of Radiology, Hospital Juan Canalejo, Coruna (Spain); Lopez-Fernandez, F. [Department of Hematology, Hospital Juan Canalejo, Coruna (Spain)

    2002-04-01

    The aim of this study was to define a system for scoring hemophilic arthropathy (HA) based on MR findings, providing for objective evaluation of the degree of joint involvement and evolution after on-demand administration of FVIII substitutional therapy or prophylactic treatment. A total of 133 MR examinations (89 basal and 44 during follow-up) were performed in 25 patients. Patients were divided in two groups depending on the therapy received and the length of time that the disease had been evolving at the start of the study. Group I was composed of 10 patients with secondary prophylaxis and group II was composed by 15 treated on demand. T1-weighted and T2*-weighted images performed on a 0.5-T unit were prospectively evaluated. The joint involvement was established on a scale of 0 (no abnormalities), I (minimal amount of hemosiderin), II (large amount of hemosiderin and isolated cartilaginous erosion), III (cartilage destruction, bone erosions, and subchondral cysts) to IV (large internal joint derangement, secondary osteoarthritis and/or ankylosis). At basal MR examination, patients of group I showed no abnormalities (n=28, 75.6%), grade I (n=3), and grade II (n=6) of HA. Patients of group II corresponded to MR grades III (n=21) and IV (n=11) of HA. The MR follow-up showed improvement in three joints of group I and worsening in 5 joints in group I and 2 joints in group II. Early signs of HA were detected in 10 joints with MR imaging but were underestimated on plain radiographs. Advanced degrees of HA were classified as severe under both imaging techniques. Magnetic resonance is the preferred imaging technique to assess HA. The earliest signs of joint damage, detected by MR, are overlooked by plain radiography. The MR scoring system can be used for evaluating HA. Follow-up MR should be performed to evaluate regression or worsening of the abnormalities, primarily in the case of patients with prophylaxis who usually suffer normal or early joint involvement not

  15. Effect of anakinra on arthropathy in CINCA/NOMID syndrome

    Directory of Open Access Journals (Sweden)

    Kaneko Utako

    2010-03-01

    Full Text Available Abstract CINCA/NOMID is an autoinflammatory disorder characterized by the triad of neonatal onset of cutaneous symptoms, chronic meningitis, and recurrent fever and it presents with distinctive osteoarthropathy, synovitis mainly of the large joints and overgrowth of epimetaphyseal cartilage, particularly of the long bones. The cartilage overgrowth eventually causes osseous overgrowth and deformity that persists beyond skeletal maturity and leads to limb length discrepancy, joint contracture, and early degenerative arthropathy. Autoinflammation in CAPS/NOMID has been proven to derive from excessive release of interleukin-1 (IL-1. It has been well documented that the IL-1 receptor antagonist anakinra (Kineret(R helps mitigate systemic inflammation in the disorder. However, a general consensus has not been reached on its beneficial effect on osteoarthropathy. The case of a girl with CINCA/NOMID syndrome who showed dramatic improvement of osteoarthropathy after anakinra treatment is reported. A 4-year-old girl suffered at the age of 10 months from a generalized urticarial skin lesion with recurrent episodes of fever and growth disorder. Blood examination revealed persistent massive neutrophilia, anemia and intense acute phase response. She manifested knee joint swelling with limited ROM when she was 20 months old and was diagnosed as being CINCA/NOMID based on characteristic findings of radiograph despite negative CIAS1 mutation. Radiological examination demonstrated metaphyseal fraying and cupping and widening of the growth plate in the distal femur. MR imaging showed mottled gadolinium enhancement at the chondrosseous junction. Neither significant joint effusion nor synovitis was identified. At 2 years and 7 months of age, anakinra, 2 mg/kg/day given by regular daily subcutaneous injections, was started. A few days after the initiation of the treatment, her clinical symptoms and laboratory findings of active inflammation were promptly alleviated

  16. Cost-effectiveness analyses of elective orthopaedic surgical procedures in patients with inflammatory arthropathies

    DEFF Research Database (Denmark)

    Osnes-Ringen, H.; Kvamme, M. K.; Sønbø Kristiansen, Ivar;

    2011-01-01

    (SD 13) years, 77% female] with inflammatory arthropathies underwent orthopaedic surgical treatment and responded to mail surveys at baseline and during follow-up (3, 6, 9, and 12 months). Questionnaires included the quality-of-life EuroQol-5D (EQ-5D) and Short Form-6D (SF-6D) utility scores. The...

  17. Membranoproliferative glomerulonephritis presenting as arthropathy and cardiac valvulopathy in hypocomplementemic urticarial vasculitis: a case report

    OpenAIRE

    Park, Chuiyoung; Choi, Seung Won; Kim, Misung; Park, Jongha; Lee, Jong Soo; Chung, Hyun Chul

    2014-01-01

    Introduction Hypocomplementemic urticarial vasculitis syndrome is a rare disorder characterized by chronic urticarial vasculitis, arthralgia, arthritis, and hypocomplementemia. Previously, only six patients with concomitant hypocomplementemic urticarial vasculitis syndrome, Jaccoud’s arthropathy, and valvular heart disease have been reported. Case presentation A 30-year-old Korean man presented with hypocomplementemic urticarial vasculitis syndrome. In addition to urticarial cutaneous lesions...

  18. HTLV-1-associated arthropathy treated with anti-TNF-alpha agent.

    Science.gov (United States)

    Frenzel, Laurent; Moura, Bertrand; Marcais, Ambroise; Chapdelaine, Hugo; Hermine, Olivier

    2014-07-01

    Human T cell leukemia virus type 1 or HTLV-1 infection is a public health problem in endemic regions like Japan, Central America or Africa. Although the majority of HTLV-1 carriers remain asymptomatic throughout their lives, some patients could develop neurological disorder, inflammatory arthropathy also called HTLV-1-associated arthropathy or T-cell malignancy, the adult T-cell leukemia/lymphoma or ATL with a very poor prognosis. Described to be very close to rheumatoid arthritis, HTLV-1-associated arthropathy patients have few or no response to the first line therapy with corticosteroids and disease modifying antirheumatic drugs or DMARDs. The use of anti-TNF-α agents in these patients is an interesting alternative but asks the question of risk of developing an adult T-Cell leukemia/lymphoma. We reported an exceptional case of a smoldering ATL patient with an HTLV-1-associated arthropathy, refractory to corticosteroid, DMARDs and rituximab therapy, treated successfully with etanercept, without progression to aggressive ATL after 5 years.

  19. Pneumocystis carinii pneumonia complicating low dose methotrexate treatment for psoriatic arthropathy.

    OpenAIRE

    Wallis, P J; Ryatt, K S; Constable, T J

    1989-01-01

    A case of Pneumocystis carinii pneumonia complicating low dose methotrexate treatment for psoriasis and psoriatic arthropathy is described. This potentially fatal event was probably precipitated by an interaction between methotrexate and concurrent non-steroidal anti-inflammatory drugs, resulting in serious potentiation of the effects of methotrexate.

  20. Physiotherapy Treatment in Patients with Hemophilia and Chronic Ankle Arthropathy: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Rubén Cuesta-Barriuso

    2013-01-01

    Full Text Available Haemophilic arthropathy of the ankle causes pain and deterioration in gait, causing disability. Although some physiotherapy modalities are effective in the management of acute bleeding, the results are unknown in chronic arthropathy. Our objective was to determine the most effective physiotherapy procedures for treating the haemophilic arthropathy of the ankle and to assess the methodological quality of the studies. A systematic review was carried out in the Cochrane Database, PubMed, MEDLINE, ISI Web of Knowledge, PEDro, TESEO, and specialized journals (Haemophilia and Haematologica. It included articles with at least one group undergoing any kind of physiotherapy treatment and with pretest and posttest evaluation, published before April 2013. An analysis of variables was performed and assessed the methodological quality of studies. Five studies met the criteria for inclusion. Hydrotherapy treatments, strength training and balance strength, balance training, and sports therapy, have improved range of movement, pain, balance, and subjective physical performance. The proposed methodological analysis was not possible due to the low quality of the studies. Although the results are positive, they lack rigorous evidence on the effects of treatments. Studies are needed to establish the efficacy of the various forms of physiotherapy in the haemophilic arthropathy of the ankle.

  1. Neurotrophic arthropathy of the shoulder secondary to tuberculous arachnoiditis: a case report.

    Science.gov (United States)

    Nissenbaum, M

    1976-01-01

    A rapidly progressive neurotrophic arthropathy of the shoulder was noted in a 44-year-old man with tuberculous adhesive arachnoiditis. Difficulty in making the diagnosis of adhesive arachnoiditis was encountered because of the variable and confusing neurologic manifestations until a cisternal myelogram was performed and this previously unreported relationship established.

  2. The feasibility of total ankle prosthesis for severe arthropathy in haemophilia and prothrombin deficiency.

    NARCIS (Netherlands)

    Heide, H.J. van der; Nováková, I.R.O.; Waal Malefijt, M.C. de

    2006-01-01

    The standard treatment for end-stage arthropathy of the ankle joint in haemophilia has been fusion of the ankle joint. Total ankle replacement is used in osteoarthritis and especially in rheumatoid arthritis with good medium-term results. In this case series three patients are being described, in wh

  3. Integrative Approach in Haemophillic Arthropathy of The Knee: a Case Report

    Directory of Open Access Journals (Sweden)

    Andri Maruli T Lubis

    2016-05-01

    Full Text Available Haemophilic arthropathy is the most prevalent joint disorder in haemophilia. This disorder is characterized by chronic synovitis and progressive destruction of joint cartilage. We report a case of arthroscopic synovectomy to reduce bleeding frequency in haemophilic arthropathy of the knee. Patient was a 15 years old male with haemophilic arthropathy of the left knee. We performed an arthroscopic synovectomy under tightly regulated factor VIII replacement therapy. There were villous synovial hypertrophy at all part of the joint, multiple bone and cartilage defect, and also anterior cruciate ligament (ACL and posterior cruciate ligament (PCL deficiency found intraoperatively. After 6 month follow up, subjective complain and bleeding frequency decreased significantly. The visual analog scale improved from 5-6 to 1-2, and the International Knee Documentation Committee Score increased from 49 to 66. Bleeding frequency decreased from 4-8 times per month to less than 1 time per month. Arthroscopic synovectomy performed in this case could reduce the pain, decrease the frequency of bleeding, and improve patient’s functional outcome. Key words: arthroscopic synovectomy, haemophilic arthropathy, haemophilia, anterior cruciate ligament, posterior cruciate ligament.

  4. Anti-citrullinated peptide antibodies in lupus patients with or without deforming arthropathy.

    Science.gov (United States)

    Damián-Abrego, G N; Cabiedes, J; Cabral, A R

    2008-04-01

    The objective was to study the association of antibodies against cyclic citrullinated peptides (anti-CCP) in patients with lupus articular damage. We studied 34 systemic lupus erythematosus patients (30 women) with (n = 14) or without (n = 20) deforming arthropathy. Anti-DNA and arthritis were mandatory inclusion criteria for both groups. As controls, 34 patients with rheumatoid arthritis and nine patients with rheumatoid arthritis and systemic lupus erythematosus (rhupus) were included. Anti-CCP and rheumatoid factor were determined by ELISA and nephelometry respectively. All patients had recent x-ray films of the hands that were evaluated according to Sharp's method. Systemic lupus erythematosus patients had a mean 6.50 +/- 0.86 (SD, range 5-8) American College of Rheumatology (ACR) criteria, rheumatoid arthritis patients met 5.38 +/- 0.60 (range 4-6) ACR criteria for rheumatoid arthritis and rhupus patients had 5.78 +/- 0.44 (range 5-6) criteria for rheumatoid arthritis and 5.11 +/- 0.78 (range 4-6) for systemic lupus erythematosus. Systemic lupus erythematosus patients, with or without deforming arthropathy, had normal serum anti-CCP concentrations. In contrast, rheumatoid arthritis and rhupus patients had 30- and 23-fold higher than normal amounts of anti-CCP (p lupus deforming arthropathy were more frequently positive for rheumatoid factor (65%) than patients with non-deforming arthritis (15%) (p = 0.005). Patients with lupus deforming arthropathy had similar frequency of erosions and mean Sharp's score than rhupus patients. Anti-CCP antibodies do not associate with lupus arthropathy, whether deforming, non-deforming or erosive.

  5. Neurogenic dysphagia resulting from Chiari malformations.

    Science.gov (United States)

    Pollack, I F; Pang, D; Kocoshis, S; Putnam, P

    1992-05-01

    Between 1980 and 1989, 15 of 46 patients (11 children, 4 adults) who underwent suboccipital craniectomy and cervical laminectomy for symptomatic Chiari malformations presented with manifestations of neurogenic dysphagia. Each of these patients had normal swallowing function before the development of dysphagic symptoms. Dysphagia was progressive in all 15 and, in most cases, preceded the onset of other severe brain stem signs. The rate of symptom progression varied depending on the age of the patient. Whereas the six infants (all Chiari II) deteriorated rapidly after the onset of initial symptoms, the five older children (two Chiari I, three Chiari II) and four adults (all Chiari I) showed a more gradual deterioration. In 11 patients with severe dysphagia, barium video esophagograms, pharyngoesophageal motility studies, continuous esophageal pH monitoring, and appropriate scintigraphic studies were useful in defining the scope of the swallowing impairment and determining whether perioperative nasogastric or gastrostomy feedings, gastric fundoplication, and/or tracheostomy were needed to maintain adequate nutrition and avoid aspiration. These patients all had widespread dysfunction of the swallowing mechanism, with a combination of diffuse pharyngoesophageal dysmotility, cricopharyngeal achalasia, nasal regurgitation, tracheal aspiration, and gastroesophageal reflux. The pathophysiology of these swallowing impairments and their relation to the hindbrain malformation is discussed. Postoperative outcome with regard to swallowing function correlated with the severity of preoperative symptoms. The four patients with mild dysphagia showed rapid improvement in swallowing function after surgery. Seven patients with more severe impairment but without other signs of severe brain stem compromise, such as central apnea or complete bilateral vocal cord paralysis, also improved, albeit more slowly. In contrast, the outcome in the four patients who developed other signs of severe

  6. Survey of spinal cord injury-induced neurogenic bladder studies using the Web of Science

    OpenAIRE

    Zou, Benjing; Zhang, Yongli; Li, Yucheng; WANG, ZANTAO; Zhang, Ping; Zhang, Xiyin; Wang, Bingdong; Long, Zhixin; Wang, Feng; SONG, GUO; Yan WANG

    2012-01-01

    OBJECTIVE: To identify global trends in research on spinal cord injury-induced neurogenic bladder, through a bibliometric analysis using the Web of Science. DATA RETRIEVAL: We performed a bibliometric analysis of studies on spinal cord injury-induced neurogenic bladder using the Web of Science. Data retrieval was performed using key words “spinal cord injury”, “spinal injury”, “neurogenic bladder”, “neuropathic bladder”, “neurogenic lower urinary tract dysfunction”, “neurogenic voiding dysfun...

  7. A case of arthropathy and hypothyroidism during recombinant alpha-interferon therapy.

    Science.gov (United States)

    Maccari, S; Bassi, C; Giovannini, A G; Plancher, A C

    1991-12-01

    Late side effects of alpha-interferon therapy include some autoimmune diseases, such as thyroiditis. We present the case of a patient with severe chronic active hepatitis and hepatitis-C-virus positivity, who during alpha-interferon therapy developed an autoimmune thyroiditis and at the same time arthropathy with some characteristics of rheumatoid arthritis (several articular stations simultaneously affected, involvement of the hand joints and morning stiffness). PMID:1666349

  8. Septic arthritis and arthropathy of the rotator cuff: remember this association

    Directory of Open Access Journals (Sweden)

    Danilo Sobreira

    2016-08-01

    Full Text Available ABSTRACT OBJECTIVE: To describe occurrences of septic glenohumeral arthritis among patients with arthropathy of the rotator cuff, and to highlight the importance of correct diagnosis and surgical procedures. METHODOLOGy: Eight surgical drains were installed in seven patients with glenohumeral pyoarthritis. All the patients presented arthropathy of the rotator cuff (four males and three females. Six patients presented pyoarthritis in the dominant shoulder. The age range was from 53 to 93 years (mean: 74 years. The mean duration of the symptoms before the surgical lavage was six weeks. Six patients underwent treatment consisting of a combination of arthroscopic irrigation and debridement, and one patient was treated by means of open arthrotomy. All the patients received systemic antibiotic therapy in accordance with their bacterial sensitivity. RESULTS: All seven patients achieved satisfactory results, taking into consideration especially the improvement of pain and the patients' satisfaction. The functional assessment was performed using the University of California Los Angeles (UCLA scale. Only one patient needed to go through another arthroscopic procedure. Staphylococcus aureus was isolated from four cultures and Escherichia coli from one culture. There were two situations in which the patients used empirical antibiotic therapy and the cultures showed negative results. Among the associated procedures, tenotomy of the biceps was performed in four cases, resection of the lateral third of the clavicle due to osteomyelitis in one case and arthrotomy of the knee in one case. CONCLUSION: Surgical treatment was effective in the cases of arthritis associated with arthropathy of the rotator cuff. In patients with arthropathy of the rotator cuff and subclinically altered laboratory signs, the possibility of pyoarthritis should always be suspected.

  9. Radiologic findings of hemophilic arthropathy of the knee : Focusing on MR imaging and plain radiography

    International Nuclear Information System (INIS)

    To evaluate the characteristic MR findings of hemophilic arthropathy of the knee. Seven keens in six patients with hemophilia (five hemophilia A and one hemophilia B) were retrospectively studied with MR images and plain radiographs. Patients were aged between 2 and 20 years (mean, 11) and all had a clinical history of repeated hemarthrosis. MR images of the knee were analyzed with respect to intra- and extra-articular hemorrhage, the state of synovial tissue, articular cartilage, bone, menisci, and ligaments. Synovial hypertrophy and articular cartilage destruction were revealed in all seven knees ; pannus was found in four, and was seen as low signal intensity on T1-weighted image and high signal intensity on T2-weighted images. All five instances of synovial hypertrophy and pannus were enhanced. Joint effusion, presented in five of seven knees, demonstrated slightly low signal intensity on T1-weighted image and high signal intensity on T2-weighted images, and was associated with peripheral low signal intensity of hemosiderin. Subchondral and marginal erosion was seen in six cases, patellar deformity in three, meniscal damage in four and cruciate ligament damage in one case. MR is superior to radiography in demonstrating chronic repeated hemarthrosis (manifested as thick intra-articular effusion), hemosidering, synovial hypertrophy, erosion or destruction of articular cartilage and bone, and meniscal or cruciate ligament injury of hemophilic arthropathy of the knee. MR is therefore thought to be a useful imaging study for accurate evaluation of hemophilic arthropathy of the knee

  10. The role of extended scope physiotherapists in managing patients with inflammatory arthropathies: a systematic review

    Directory of Open Access Journals (Sweden)

    Stanhope J

    2012-05-01

    Full Text Available Jessica Stanhope,1 Kate Beaton,1 Karen Grimmer-Somers,1 Joanne Morris21International Centre for Allied Health Evidence (iCAHE, University of South Australia, Adelaide, South Australia; 2ACT Government Health Directorate, Canberra, Australian Capital Territory, AustraliaObjectives: To review the literature to identify whether, and how, physiotherapists working in extended scope of practice (ESP engage with patients with inflammatory arthropathies. Measures of effectiveness of ESP were particularly sought.Methods: A comprehensive library database search was conducted to identify English language studies published in full text in peer-reviewed journals during the years 2002–2012. Studies were allocated into the National Health and Medical Research Council hierarchy of evidence, but were not critically appraised. Data was extracted on conditions treated, ESP roles and responsibilities, and effectiveness. Data was analyzed and reported descriptively.Results: We identified 123 studies, and included four. All were low hierarchy (highest being one level III_2 study. Commonly reported conditions were rheumatoid arthritis and ankylosing spondylitis. Information was provided on activities of role extension, such as triaging patients, monitoring and recommending changes to medications, referring to other health and medical professionals, and ordering and interpreting imaging. There was blurring between ESP and non-ESP roles. No study reported measures of effectiveness.Conclusion: There are descriptors of ESP physiotherapy activities, but no evidence of effectiveness of ESP physiotherapy in managing patients with inflammatory arthropathies.Keywords: ESP, extended scope, rheumatoid arthritis, ankylosing spondylitis, inflammatory arthropathy, physiotherapy

  11. Hemophilic arthropathy of the knee joint: static and dynamic Gd-DTPA - enhanced MRI

    Energy Technology Data Exchange (ETDEWEB)

    Naegele, M. [Dept. of Radiology, Univ. Bonn (Germany); Bruening, R. [Dept. of Radiology, Univ. Muenchen (Germany); Kunze, V. [Dept. of Radiology, Univ. Bonn (Germany); Eickhoff, H. [Dept. of Orthopedic Surgery, Troisdorf (Germany); Koch, W. [Dept. of Orthopedic Surgery, Troisdorf (Germany); Reiser, M. [Dept. of Radiology, Univ. Muenchen (Germany)

    1995-12-31

    A total of 17 patients with hemophilic arthropathy of the knee joint were studied with static and dynamic MRI before and after an IV bolus injection of Gadolinium-DTPA (Gd-DTPA; 0.1 mmol/kg body weight). The T1-weighted spin-echo (SE) and gradient-echo (fast-field echo [FFE]) sequences were applied. The FFE sequences of eight consecutive scans carried out over a time interval of 160 s were used in order to determine the time to signal intensity (SI) curves of the synovial proliferations surrounding soft tissue, bone marrow, and joint effusion. After the administration of a contrast agent, synovial proliferations exhibited an increase on FFE and SE images of 47.7% (SD {+-} 14.3%) and 37.4% (SD {+-} 11.2%), respectively, whereas muscle and fatty tissue, tendons, bone marrow, and joint effusion revealed only a minor increase in SI. The gradient of SI (ratio SI/time) of pannus was 39.6%/min (SD {+-} 7.7%/min) and differed significantly (P < 0.001) from that of bone marrow, fatty tissue, muscle tissue, tendons, and joint effusion (P < 0.05). In contrast to synovial proliferations in rheumatoid arthritis, no differentiation between various pannus vascularities based on the degree of enhancement was possible. The Gd-DTPA-enhanced MRI studies delineate and quantify the synovial proliferations in hemophilic arthropathy. Dynamic studies in hemophilic arthropathy do not provide qualitative assessment of the inflammatory process. (orig.)

  12. Radiologic findings of hemophilic arthropathy of the knee : Focusing on MR imaging and plain radiography

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Byung Jin; Choi, Jae Young; Cha, Sung Suk; Eun, Choong Kie [Inje Univ., College of Medicine, Pusan (Korea, Republic of); Park, Dong Woo [Hanyang Univ., College of Medicine, Seoul (Korea, Republic of)

    1996-12-01

    To evaluate the characteristic MR findings of hemophilic arthropathy of the knee. Seven keens in six patients with hemophilia (five hemophilia A and one hemophilia B) were retrospectively studied with MR images and plain radiographs. Patients were aged between 2 and 20 years (mean, 11) and all had a clinical history of repeated hemarthrosis. MR images of the knee were analyzed with respect to intra- and extra-articular hemorrhage, the state of synovial tissue, articular cartilage, bone, menisci, and ligaments. Synovial hypertrophy and articular cartilage destruction were revealed in all seven knees ; pannus was found in four, and was seen as low signal intensity on T1-weighted image and high signal intensity on T2-weighted images. All five instances of synovial hypertrophy and pannus were enhanced. Joint effusion, presented in five of seven knees, demonstrated slightly low signal intensity on T1-weighted image and high signal intensity on T2-weighted images, and was associated with peripheral low signal intensity of hemosiderin. Subchondral and marginal erosion was seen in six cases, patellar deformity in three, meniscal damage in four and cruciate ligament damage in one case. MR is superior to radiography in demonstrating chronic repeated hemarthrosis (manifested as thick intra-articular effusion), hemosidering, synovial hypertrophy, erosion or destruction of articular cartilage and bone, and meniscal or cruciate ligament injury of hemophilic arthropathy of the knee. MR is therefore thought to be a useful imaging study for accurate evaluation of hemophilic arthropathy of the knee.

  13. Neurogenic differentiation of amniotic fluid stem cells.

    Science.gov (United States)

    Rosner, M; Mikula, M; Preitschopf, A; Feichtinger, M; Schipany, K; Hengstschläger, M

    2012-05-01

    In 2003, human amniotic fluid has been shown to contain stem cells expressing Oct-4, a marker for pluripotency. This finding initiated a rapidly growing and very promising new stem cell research field. Since then, amniotic fluid stem (AFS) cells have been demonstrated to harbour the potential to differentiate into any of the three germ layers and to form three-dimensional aggregates, so-called embryoid bodies, known as the principal step in the differentiation of pluripotent stem cells. Marker selection and minimal dilution approaches allow the establishment of monoclonal AFS cell lineages with high proliferation potential. AFS cells have a lower risk for tumour development and do not raise the ethical issues of embryonic stem cells. Compared to induced pluripotent stem cells, AFS cells do not need exogenic treatment to induce pluripotency, are chromosomal stable and do not harbour the epigenetic memory and accumulated somatic mutations of specific differentiated source cells. Compared to adult stem cells, AFS can be grown in larger quantities and show higher differentiation potential. Accordingly, in the recent past, AFS became increasingly accepted as an optimal tool for basic research and probably also for specific cell-based therapies. Here, we review the current knowledge on the neurogenic differentiation potential of AFS cells.

  14. Clinical And Radiological Assessment Of Deferiprone Related Knee Arthropathy In Children With P-Thalassemia Major

    International Nuclear Information System (INIS)

    Objectives: To evaluate deferiprone related knee arthropathy in patients with fi-thalassemia major undergoing chelation therapy with deferiprone (LI). Materials and Methods. This study included 40 patients with β- thalassemia major on deferiprone; their ages ranged from 8 to 18 years with a mean age of 12.6 ± 3 years. Forty age and sex matched patients on desferal served as controls. Patients were subjected to clinical knee joint examination using the modified hemophilia joint health score (JHS), bilateral knee joint X-ray and bilateral knee joint ultrasound. Twenty patients of the deferiprone group with positive knee joint ultrasound findings were subjected to knee MRI. Data collected included age, sex, transfusion index, chelation history (dose, duration, and adverse effects), history of splenectomy and symptoms of knee or other joints arthropathy. Weight, height, BMI and Tanner staging of the patients were recorded. Laboratory investigations included CBC, ALT, serum ferritin, viral hepatitis markers (B,C) and echocardiography. Results: Among deferiprone group; 25 patients (62.5%) had knee symptoms while; 93.3% of the asymptomatic patients had evidence of knee joint affection by JHS compared to 17 symptomatic patients (42.5%) among desferal group (ρ> 0.05). Among deferiprone group 7 patients (17.5%) had symptoms of other joints arthropathy. Knee symptoms were more prevalent with longer duration of deferiprone therapy (ρ<0.05), knee joint effusion in US (ρ< 0.05) and Higher platelet count (ρ<0.05), while in desferal group it was related to poor compliance (ρ< 0.01) and higher serum ferritin levels (ρ=<0.01). JHS ranged from 0-33 with 39 (97.5%) affected patients. JHS was positively correlated to age, weight, height, BMI, Tanner staging and platelet count (ρ<0.01), and negatively correlated to transfusion index (ρ<0.01) with no significant correlation to ultrasound or MRI findings. JHS was higher among splenectomized patients in both groups (ρ<0.01). No

  15. Capsaicin-induced neurogenic inflammation in the skin in patients with symptoms induced by odorous chemicals

    DEFF Research Database (Denmark)

    Holst, Helle; Arendt-Nielsen, Lars; Mosbech, Holger;

    2011-01-01

    Intradermal injection of capsaicin induces the axonal release of neuropeptides, vasodilatation and flare, e.g. neurogenic inflammation. The spatial profile of neurogenic inflammation in the skin has been studied in various experimental models. Polarization spectroscopy imaging introduced recently...

  16. Discerning neurogenic vs. non-neurogenic postnatal lateral ventricular astrocytes via activity-dependent input

    Directory of Open Access Journals (Sweden)

    Elena W. Adlaf

    2016-03-01

    Full Text Available Throughout development, neural stem cells (NSCs give rise to differentiated neurons, astrocytes, and oligodendrocytes which together modulate perception, memory, and behavior in the adult nervous system. To understand how NSCs contribute to postnatal/adult brain remodeling and repair after injury, the lateral ventricular (LV neurogenic niche in the rodent postnatal brain serves as an excellent model system. It is a specialized area containing self-renewing GFAP+ astrocytes functioning as NSCs generating new neurons throughout life. In addition to this now well-studied regenerative process, the LV niche also generates astrocytes, playing an important role for glial scar formation after cortical injury. While LV NSCs can be clearly distinguished from their neuroblast and oligodendrocyte progeny via molecular markers, the astrocytic identity of NSCs has complicated their distinction from terminally-differentiated astrocytes in the niche. Our current models of postnatal/adult LV neurogenesis do not take into account local astrogenesis, or the possibility that cellular markers may be similar between non-dividing GFAP+ NSCs and their differentiated astrocyte daughters. Postnatal LV neurogenesis is regulated by NSC-intrinsic mechanisms interacting with extracellular/niche-driven cues. It is generally believed that these local effects are responsible for sustaining neurogenesis, though behavioral paradigms and disease states have suggested possibilities for neural circuit-level modulation. With recent experimental findings that neuronal stimulation can directly evoke responses in LV NSCs, it is possible that this exciting property will add a new dimension to identifying postnatal/adult NSCs. Here, we put forth a notion that neural circuit-level input can be a distinct characteristic defining postnatal/adult NSCs from non-neurogenic astroglia.

  17. Neurogenic Bladder Repair Using Autologous Mesenchymal Stem Cells.

    Science.gov (United States)

    Mahajan, Pradeep V; Subramanian, Swetha; Danke, Amit; Kumar, Anand

    2016-01-01

    The normal function of the urinary bladder is to store and expel urine in a coordinated, controlled fashion, the activity of which is regulated by the central and peripheral nervous systems. Neurogenic bladder is a term applied to a malfunctioning urinary bladder due to neurologic dysfunction or insult emanating from internal or external trauma, disease, or injury. This report describes a case of neurogenic bladder following laminectomy procedure and long-standing diabetes mellitus with neuropathy treated with autologous cellular therapy. The differentiation potential and paracrine effects of mesenchymal stem cells on bladder function have been highlighted. PMID:27656308

  18. Artropatía neuropática de hombro Neuropathic arthropathy of the shoulder

    Directory of Open Access Journals (Sweden)

    E. Noain

    2007-12-01

    Full Text Available Las artropatías neuropáticas conducen a un proceso de destrucción y deformación articular de rápida evolución que se ha relacionado con un trastorno de la inervación propioceptiva y nociceptiva; factores de crecimiento, neuromediadores y vasculares parecen también implicados. En nuestro medio la diabetes, la neuropatía alcohólica o siringomielia suelen ser las causas más frecuentes. Presentamos el caso de una artropatía neuropática de hombro en una mujer de 61 años con antecedente de siringomielia. El diagnóstico diferencial se plantea con entidades neurológicas, artritis sépticas, osteomielitis crónicas, tumores y otras artropatías destructivas como las osteonecrosis asépticas, condromatosis sinovial, metabólicas (gota y condrocalcinosis o hemartros de repetición en hemofílicos.Neuropathic arthropathies is a destructive and deforming joint process related to a disruption of propioceptive and nocioceptive innervation. Growth factors, neurological and vascular factors might be involved. Diabetes, alcoholic neuropathy or syringomyelia appear as the most common causes. We report the case of a 61-year-old woman affected by syringomyelia, with a neuropathic arthropathy of the shoulder. Differential diagnosis includes neurological diseases, septic arthritis, tumours and other destructive arthropathies such as aseptic nechrosis, chronic osteomyelitis, synovial chondromatosis, metabolic diseases (gout, chondrocalcinosis or repetitive haemarthrosis in haemophilia.

  19. What do standard radiography and clinical examination tell about the shoulder with cuff tear arthropathy?

    Directory of Open Access Journals (Sweden)

    Favard Luc

    2011-01-01

    Full Text Available Abstract Background This study evaluates the preoperative conventional anteroposterior radiography and clinical testing in non-operated patients with cuff tear arthropathy. It analyses the radiological findings in relation to the status of the rotator cuff and clinical status as also the clinical testing in relation to the rotator cuff quality. The aim of the study is to define the usefulness of radiography and clinical examination in cuff tear arthropathy. Methods This study analyses the preoperative radiological (AP-view, (Artro-CT-scan or MRI-scan and clinical characteristics (Constant-Murley-score plus active and passive mobility testing and the peroperative findings in a cohort of 307 patients. These patients were part of a multicenter, retrospective, consecutive study of the French Orthopaedic Society (SOFCOT-2006. All patients had no surgical antecedents and were all treated with prosthetic shoulder surgery for a painful irreparable cuff tear arthropathy (reverse-(84% or hemi-(8% or double cup-bipolar prosthesis (8%. Results A positive significancy could be found for the relationship between clinical testing and the rotator cuff quality; between acromiohumeral distance and posterior rotator cuff quality; between femoralization and posterior rotator cuff quality. Conclusion A conventional antero-posterior radiograph can not provide any predictive information on the clinical status of the patient. The subscapular muscle can be well tested by the press belly test and the teres minor muscle can be well tested by the hornblower' sign and by the exorotation lag signs. The upward migration index and the presence of femoralization are good indicators for the evaluation of the posterior rotator cuff. An inferior coracoid tip positioning suggests rotator cuff disease.

  20. MicroRNA-15b Modulates Molecular Mediators of Blood Induced Arthropathy in Hemophilia Mice

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    Dwaipayan Sen

    2016-04-01

    Full Text Available The development of arthropathy is a major co-morbidity in patients with hemophilia. The present study was designed to study the role of a microRNA biomarker (miR-15b in the development of joint disease. To investigate the expression profile of miR-15b during the development of arthropathy, we first isolated and studied small RNA from the acute and chronic hemarthrosis model of hemophilia A mice. We observed that miR-15b was consistently repressed (~1- to 4-fold from the onset of joint bleeding (1, 3, 7 and 24 h until six bleeding episodes (up to 90 days. To test if reconstitution of miR-15b modulates biomarkers of joint damage in a chronic hemarthrosis model, we administered an adeno-associated virus (AAV 5-miR-15b vector intra-articularly alone or in combination with systemic administration of AAV2-factor VIII. miR-15b overexpression downregulated markers of angiogenesis and hypoxia (vascular epithelial growth factor α (VEGF-α and hypoxia inducing factor 2α (HIF-2α, ~70% and ~34%, respectively in the affected joints. In addition, the co-administration of miR-15b and factor VIII vectors reduced the levels of the chondrodegenerative matrix-metalloproteinases (MMPs 1, 3, 9 and 14 (~14% to 60% in the injured joints. These data demonstrate for the first time the role of a miR-15b in the development of hemophilic arthropathy and has implications in development of miR based therapies for joint disease.

  1. Mapping of potential neurogenic niche in the human temporal lobe

    Directory of Open Access Journals (Sweden)

    Adriano Barreto Nogueira

    2014-10-01

    Full Text Available The subgranular zone (SGZ of the dentate gyrus and the subventricular zone (SVZ are known neurogenic niches in adult mammals. Nonetheless, the existence of neurogenic niches in adult humans is controversial. We hypothesized that mapping neurogenic niches in the human temporal lobe could clarify this issue. Neurogenic niches and neurogenesis were investigated in 28 temporal lobes via immunostaining for nestin and doublecortin (DCX, respectively. Nestin was observed in a continuous layer formed by the SVZ, the subpial zone of the medial temporal lobe and the SGZ, terminating in the subiculum. In the subiculum, remarkable DCX expression was observed through the principal efferent pathway of the hippocampus to the fimbria. A possible explanation for the results is that the SVZ, the subpial zone of the medial temporal lobe and the SGZ form a unit containing neural stem cells that differentiate into neurons in the subiculum. Curiously, the area previously identified as the human rostral migratory stream may in truth be the fornix, which contains axons that originate in the subiculum. This study suggests that neurogenesis may occur in an orchestrated manner in a broad area of the human temporal lobe.

  2. Neurogen dysfagi ses hyppigt hos patienter på intensivafdelinger

    DEFF Research Database (Denmark)

    Pedersen, Anette Barbre; Kjærsgaard, Annette; Larsen, Jens Kjærgaard Rolighed;

    2015-01-01

    Neurogenic oropharyngeal dysphagia (NOD) is a frequent condition in neurological patients admitted to the ICU, particularly in patients with brainstem lesions. The CNS damage itself can predispose to dysphagia, but also the treatment and preventive measures may predispose to and exacerbate...... rehabilitation is important....

  3. SUSCEPTIBILITY TO POLLUTANT-INDUCED AIRWAY INFLAMMATION IS NEUROGENICALLY MEDIATED.

    Science.gov (United States)

    Neurogenic inflammation in the airways involves the activation of sensory irritant receptors (capsaicin, VR1) by noxious stimuli and the subsequent release of neuropeptides (e.g., SP, CGRP, NKA) from these fibers. Once released, these peptides initiate and sustain symptoms of ...

  4. Sympathoadrenal dysfunction in rats with chronic neurogenic hypertension

    OpenAIRE

    Dominiak, P; Kees, Frieder K.; Grobecker, H

    1985-01-01

    Compared to sham-operated controls 5 weeks after surgery neurogenic hypertensive rats with sino-aortic baroreceptor deafferentation had higher blood pressure, higher plasma noradrenaline and adrenaline levels, lower heart noradrenaline concentrations, higher adrenomedullary adrenaline levels and increased cardiac intraventricular pressure (dp/dtmax).

  5. Comparison of multiple imaging in detection of arthropathies in patients with haemophilia

    International Nuclear Information System (INIS)

    Objective: To compare the diagnostic value of magnetic resonance imaging (MRI),computed tomography (CT) and radiography in the early detection of arthropathies of haemophilia. Methods: Prospective studies of 21 joints in 11 patients were studied with X-ray, CT and MR examination. The 21 joints with haemophilia arthropathies were divided into three groups according to Pettersson scoring system. 0 point were the first group, <4 points were the second group, ≥4 points were the third group. Abnormal imaging findings of osteoporosis,enlarge epiphysis, erosion of cartilage,irregular subchondral surface, narrowing of joints space, joint deformity, subchondral cyst formation, effusion/haemarthrosis of joint, synovial hypertrophy with haemosiderin, deformity of joints were used for all imaging comparison. The results were analysis with Chi-square test. To compare the first group, irregular subchondral surface and the number of subchondral cyst formation of all symptomatic joints were detected by CT and MR, the results were analysis with pair-sample t test. Results: Moderate and severe hemophilic joints were found in 80.95% (17/21)of twenty-one symptomatic joints, and mild hemophilic joints were found in 19.05% (4/21). The detected results were the same in enlarge epiphysis, narrowing of joints space,joint deformity in all joints by radiography, CT and MR. Significant difference in detection of irregular subchondral surface, subchondral cyst formation, effusion/haemarthrosis of joint, were found between radiography with either CT (χ2 value 19.06, 16.70, 4.84, P<0.05) or MRI (χ2 value 19.06, 16.70, 7.76, P<0.05), Significant difference in detection of the first group joint irregular subchondral surface and the subchondral cyst formation total number were found between CT and MR (χ2=3.29, P<0.05). Conclusions: MR and CT were superior in detection of the early abnormal changes in evaluating hemophilic arthropathies, however CT could detect more smaller irregular

  6. The treatment of erectile dysfunction in patients with neurogenic disease

    Science.gov (United States)

    Brant, William O.

    2016-01-01

    Erectile dysfunction (ED) related to compromise of the nervous system is an increasingly common occurrence. This may be due to the multifactorial nature of ED, the myriad of disorders affecting the neurotransmission of erectogenic signals, and improved awareness and diagnosis of ED. Nevertheless, neurogenic ED remains poorly understood and characterized. Disease related factors such as depression, decreased physical and mental function, the burden of chronic illness, and loss of independence may preclude sexual intimacy and lead to ED as well. The amount of data regarding treatment options in subpopulations of differing neurologic disorders remains scarce except for men with spinal cord injury. The treatment options including phosphodiesterase inhibitors, intracavernosal or intraurethral vasoactive agents, vacuum erection devices (VED) and penile prosthetic implantation remain constant. This review discusses the options in specific neurologic conditions, and briefly provides insight into new and future developments that may reshape the management of neurogenic ED. PMID:26904415

  7. Neurogenic neuroinflammation in fibromyalgia and complex regional pain syndrome.

    Science.gov (United States)

    Littlejohn, Geoffrey

    2015-11-01

    Although fibromyalgia and complex regional pain syndrome (CRPS) have distinct clinical phenotypes, they do share many other features. Pain, allodynia and dysaesthesia occur in each condition and seem to exist on a similar spectrum. Fibromyalgia and CRPS can both be triggered by specific traumatic events, although fibromyalgia is most commonly associated with psychological trauma and CRPS is most often associated with physical trauma, which is frequently deemed routine or minor by the patient. Fibromyalgia and CRPS also seem to share many pathophysiological mechanisms, among which the most important are those involving central effects. Nonetheless, peripheral effects, such as neurogenic neuroinflammation, are also important contributors to the clinical features of each of these disorders. This Review highlights the differing degrees to which neurogenic neuroinflammation might contribute to the multifactorial pathogenesis of both fibromyalgia and CRPS, and discusses the evidence suggesting that this mechanism is an important link between the two disorders, and could offer novel therapeutic targets.

  8. CLINICAL AND BIOLOGICAL BEHAVIOR OF NEUROGENIC TUMOR AFTER PREOPERATIVE CHEMOTHERAPY

    Institute of Scientific and Technical Information of China (English)

    Gao Jiechun; Dong Kuiran; Jing Baixiang

    1998-01-01

    Objective: To study the significance of preoperative chemotherapy for the treatment of neurogenic tumor in children. Methods: VMA, MYCN gene and DNA content of 21 cases of neuroblastoma treated with preoperative chemotherapy were studied with a control group. Results: Resection rate was 95.5%. Mean survival time was 28.1±10.2 months, which was significantly higher than the control group (8.8±6.8 months, P<0.01).Post chemotherapeutic VMA was lower. DNA index was also reduced and the percentage of cells in G0+G1 phases was elevated. The MYCN expression was suppressed.Conclusion: Preoperative chemotherapy can induce the apoptosis of neurogenic tumor cells and inhibit its proliferative activity.

  9. Spontaneous Bladder Perforation in an Infant Neurogenic Bladder: Laparoscopic Management

    Directory of Open Access Journals (Sweden)

    Daniel Cabezalí Barbancho

    2013-01-01

    Full Text Available Spontaneous bladder perforation is an uncommon event in childhood. It is usually associated with bladder augmentation. We are presenting a case of bladder rupture in an infant with neurogenic bladder without prior bladder surgery. Three days after lipomyelomeningocele excision the patient showed signs and symptoms of acute abdomen. The ultrasound exploration revealed significant amount of intraperitoneal free fluid and therefore a laparoscopic exploration was performed. A posterior bladder rupture was diagnosed and repaired laparoscopically. Currently, being 3 years old, she keeps successfully dry with clean intermittent catheterization. Neurogenic bladder voiding function can change at any time of its evolution and lead to complications. Early diagnosis of spontaneous bladder rupture is of paramount importance, so it is essential to think about it in the differential diagnosis of acute abdomen.

  10. Neurogenic Inflammation Involves in Systemic Spread of Oral Infection

    OpenAIRE

    Haryono Utomo

    2014-01-01

    Focal infection theory proposed in early 1900’s stated that dental infection caused systemic disorders. Nevertheless, the theory was abandoned since large number of teeth were extracted with no satisfying result. Recent reports revealed that oral infections were able to spread systemically. However, there is no rationalization available to explain how assisted drainage therapy (ADT), a periodontal therapy that could relief migraine and asthma within minutes. Oral neurogenic and immunogenic in...

  11. Neurogenic pulmonary edema due to delayed radiation necrosis

    Directory of Open Access Journals (Sweden)

    Mani R

    2005-01-01

    Full Text Available Neurogenic pulmonary edema is oftten missed in the ICU setting as it is mistaken for pneumonia or ARDS. The case presented here illustrates how a high index of suspicion in the appropriate setting can lead to the diagnosis. The patient in this report developed acute-on-chronic cerebral edema due to radiation necrosis following gamma-knife radiation therapy for cerebral arteriovenous malformation.

  12. Role of Neurogenic Inflammation in Pancreatitis and Pancreatic Pain

    OpenAIRE

    Vera-Portocarrero, Louis; Karin N Westlund

    2005-01-01

    Pain arising from pancreatic diseases can become chronic and difficult to treat. There is a paucity of knowledge regarding the mechanisms that sensitize neural pathways that transmit noxious information from visceral organs. In this review, neurogenic inflammation is presented as a possible amplifier of the noxious signal from peripheral organs including the pancreas. The nerve pathways that transmit pancreatic pain are also reviewed as a conduit of the amplified signals. It is likely that co...

  13. Adult Neurogenesis: Ultrastructure of a Neurogenic Niche and Neurovascular Relationships

    OpenAIRE

    Paula Grazielle Chaves da Silva; Jeanne L Benton; Beltz, Barbara S.; Silvana Allodi

    2012-01-01

    The first-generation precursors producing adult-born neurons in the crayfish (Procambarus clarkii) brain reside in a specialized niche located on the ventral surface of the brain. In the present work, we have explored the organization and ultrastructure of this neurogenic niche, using light-level, confocal and electron microscopic approaches. Our goals were to define characteristics of the niche microenvironment, examine the morphological relationships between the niche and the vasculature an...

  14. Neurogenic pulmonary edema in a child with status epilepticus

    OpenAIRE

    Bindu T Nair; Sajith Surendran; Dinesh Yadav

    2016-01-01

    Neurogenic pulmonary edema (NPE) is defined as acute pulmonary edema after a sudden neurologic insult. It develops after a significant central nervous system insult such as trauma, hemorrhage or seizures and can occur both in adults and children. A 6-year-old male child, known case of cerebral palsy was brought to the emergency department in status epilepticus. He had severe respiratory distress with pink frothy secretions pouring from the mouth. Clinical and radiological examination was sugg...

  15. Preventing Kidney Injury in Children with Neurogenic Bladder Dysfunction

    OpenAIRE

    Faezeh Javadi Larijani; Mastaneh Moghtaderi; Nilofar Hajizadeh; Farahnak Assadi

    2013-01-01

    The most common cause of neurogenic bladder dysfunction (NBD) in newborn infants is myelomeningocele. The pathophysiology almost always involves the bladder detrusor sphincter dyssynergy (DSD), which if untreated can cause severe and irreversible damage to the upper and lower urinary tracts. Early diagnosis and adequate management of NBD is critical to prevent both renal damage and bladder dysfunction and to reduce chances for the future surgeries. Initial investigation of the affected newbor...

  16. Peripheral tumor and tumor-like neurogenic lesions

    Energy Technology Data Exchange (ETDEWEB)

    Abreu, Evandro [Service de Radiologie et Imagerie Musculosquelettique, Centre de Consultation et Imagerie de l’Appareil Locomoteur, CHRU de Lille, 59037 Lille (France); Aubert, Sébastien, E-mail: sebastien.aubert@chru-lille.fr [Institut de Pathologie, Centre de Biologie-Pathologie, CHRU de Lille, 59037 Lille (France); Wavreille, Guillaume, E-mail: guillaume.wavreille@chru-lille.fr [Service d’Orthopédie B, Hôpital R Salengro, CHRU de Lille, 59037 Lille (France); Gheno, Ramon; Canella, Clarissa [Service de Radiologie et Imagerie Musculosquelettique, Centre de Consultation et Imagerie de l’Appareil Locomoteur, CHRU de Lille, 59037 Lille (France); Cotten, Anne, E-mail: anne.cotten@chru-lille.fr [Service de Radiologie et Imagerie Musculosquelettique, Centre de Consultation et Imagerie de l’Appareil Locomoteur, CHRU de Lille, 59037 Lille (France)

    2013-01-15

    Neoplasms of neurogenic origin account for about 12% of all benign and 8% of all malignant soft tissue neoplasms. Traumatic neuroma, Morton neuroma, lipomatosis of a nerve, nerve sheath ganglion, perineurioma, benign and malignant peripheral nerve sheath tumors (PNST) are included in this group of pathologies. Clinical and radiologic evaluation of patients with neurogenic tumors and pseudotumors often reveals distinctive features. In this context, advanced imaging techniques, especially ultrasound (US) and magnetic resonance (MR) play an important role in the characterization of these lesions. Imaging findings such as location of a soft tissue mass in the region of a major nerve, nerve entering or exiting the mass, fusiform shape, abnormalities of the muscle supplied by the nerve, split-fat sign, target sign and fascicular appearance should always evoke a peripheric nerve sheath neoplasm. Although no single imaging finding or combination of findings allows definitive differentiation between benign from malign peripheric neurogenic tumors, both US and MR imaging may show useful features that can lead us to a correct diagnosis and improve patient treatment. Traumatic neuromas and Morton neuromas are commonly associated to an amputation stump or are located in the intermetatarsal space. Lipomatosis of a nerve usually appears as a nerve enlargement, with thickened nerve fascicles, embedded in evenly distributed fat. Nerve sheath ganglion has a cystic appearance and commonly occurs at the level of the knee. Intraneural perineuroma usually affects young people and manifests as a focal and fusiform nerve enlargement. In this article, we review clinical characteristics and radiologic appearances of these neurogenic lesions, observing pathologic correlation, when possible.

  17. Circulating and tissue catecholamines in rats with chronic neurogenic hypertension

    OpenAIRE

    Dominiak, P; Kees, Frieder K.; Grobecker, H

    1986-01-01

    To study the role of peripheral catecholamines in plasma and different tissues in neurogenic hypertension we measured directly blood pressure, maximum rate of left ventricular pressure rise (dp/dtmax) and heart rate through an aortic catheter 5 weeks after total sino-aortic baroreceptor deafferentation in male Sprague-Dawley rats. Blood samples were collected through the same catheter to determine plasma catecholamine concentrations. Blood pressure and dp/dtmax were significantly higher in ne...

  18. Neurogenic Tumors of the Mediastinum: A Report of 60 Cases

    Directory of Open Access Journals (Sweden)

    Salih Topçu

    2000-01-01

    Full Text Available OBJECTIVES: To analyze retrospectively 60 patients (13 infants and children, 47 adults - 21 men and 39 women with mediastinal neurogenic tumours admitted to Atatürk Centre for Chest Disease and Chest Surgery, Ankara, Turkey between 1988 and 1999. This comprised 21.2% of 283 patients who had surgical operations for all mediastinal masses during the same period.

  19. Aortitis in patients with psoriatic arthropathy: report of two cases and review of the literature

    Directory of Open Access Journals (Sweden)

    Gleb Slobodin

    2014-11-01

    Full Text Available Aortitis, which is well described in patients with other spondyloarthritides, has been rarely cited in relation to psoriatic arthropathy (PsA. Two patients with known PsA, who developed aortitis, are reported herein. The PubMed database was searched using the following keywords: aortitis, Takaysu arteritis, PsA, ankylosing spondylitis, reactive arthritis, inflammatory bowel disease. The relevant articles were critically reviewed and pertinent data organized. Analysis of 5 cases of aortitis in patients with PsA, including the 2 cases reported herein, revealed no specific pattern of PsA joint involvement in the patients who developed aortitis. All aortic segments can be involved and complications, such as insufficiency of the aortic valve and stenosis of the major aortic branches, have been described. The genetic association involving the IL12B locus may be involved in the clinical association of aortitis and spondyloarthritis.

  20. Bisphosphonates in multicentric osteolysis, nodulosis and arthropathy (MONA) spectrum disorder – an alternative therapeutic approach

    Science.gov (United States)

    Pichler, Karin; Karall, Daniela; Kotzot, Dieter; Steichen-Gersdorf, Elisabeth; Rümmele-Waibel, Alexandra; Mittaz-Crettol, Laureane; Wanschitz, Julia; Bonafé, Luisa; Maurer, Kathrin; Superti-Furga, Andrea; Scholl-Bürgi, Sabine

    2016-01-01

    Multicentric osteolysis, nodulosis and arthropathy (MONA) spectrum disorder is a rare inherited progressive skeletal disorder caused by mutations in the matrix metalloproteinase 2 (MMP2) gene. Treatment options are limited. Herein we present successful bisphosphonate therapy in three affected patients. Patients were treated with bisphosphonates (either pamidronate or zoledronate) for different time periods. The following outcome variables were assessed: skeletal pain, range of motion, bone densitometry, internal medical problems as well as neurocognitive function. Skeletal pain was dramatically reduced in all patients soon after initiation of therapy and bone mineral density increased. Range of motion did not significantly improve. One patient is still able to walk with aids at the age of 14 years. Neurocognitive development was normal in all patients. Bisphosphonate therapy was effective especially in controlling skeletal pain in MONA spectrum disorder. Early initiation of treatment seems to be particularly important in order to achieve the best possible outcome. PMID:27687687

  1. Hand deforming arthropathy (Jaccoud’s syndrome in systemic lupus erythematosus

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    A. P. Zhornyak

    2005-01-01

    Full Text Available Objective. To characterize Jaccoud’s syndrome - hand deforming arthropathy (HDA in systemic lupus erythematosus (SLE. Material and vethods. Analysis of 235 case histories of pts with SLE followed up in the Institute of Rheumatology of RAMS from 1982 to 2002 was performed. 26 from them had HDA according to D. Alarcon-Segovia criteria (1988. SLE activity was determined according to V.A Nassonova and SLEDAI-I scale. Results. 26 from 235 SLE pts (11 % had H DA. More than in 25% from them this damage formed during the first year of the disease and included nonerosive joint damage with the development of finger deformities such as "swan neck", "boutonniere", Z-deformity of thumb, muscle atrophia and ulnar deviation. Longer treatment with glucocorticoids put off HDA development (r=0,64, p=0,0003

  2. Total ankle replacement or ankle fusion in painful advanced hemophilic arthropathy of the ankle.

    Science.gov (United States)

    Rodriguez-Merchan, E Carlos

    2015-12-01

    In advanced painful hemophilic arthropathy of the ankle, the last resort is surgical treatment (ankle arthrodesis [AA] or total ankle replacement [TAR]). There is a controversy in the literature on which of the two procedures is more appropriate. A review of the literature was performed to clarify such a controversy. The first search engine was MedLine (keywords: total ankle replacement, ankle arthrodesis). Seventy articles were found in MedLine. Of these, only 16 were selected and reviewed because they were strictly focused on the topic of this article. The second search engine was the Cochrane Library, where only nine systematic reviews were found on the role of TAR and AA in non-hemophilia patients. TAR and AA provide pain relief and patient satisfaction in hemophilia patients in the short term. The available non-hemophilia literature is insufficient to conclude which treatment is superior. My current view is that AA may be preferable in most hemophilia patients.

  3. Standing worsens cognitive functions in patients with neurogenic orthostatic hypotension.

    Science.gov (United States)

    Poda, R; Guaraldi, P; Solieri, L; Calandra-Buonaura, G; Marano, G; Gallassi, R; Cortelli, P

    2012-04-01

    In previous studies, addressing the association between orthostatic hypotension and cognitive decline, patients underwent neuropsychological evaluation in sitting position, and blood pressure values and cognition were not measured concurrently. Furthermore, no studies assessed the acute effects of orthostatic hypotension on cognitive performances. The aim of our study was to evaluate the effect of a documented fall in systolic blood pressure (SBP) of at least 20 mmHg on a battery of cognitive tests in patients with neurogenic orthostatic hypotension. Ten consecutive patients with neurogenic orthostatic hypotension, normal brain imaging, and a normal Mini Mental State Examination in supine position were enrolled in the study. Patients underwent a detailed neuropsychological assessment (Brief Mental Deterioration battery and computerized tests) over two test sessions: the first while tilted to an angle able to cause a fall of at least 20 mmHg in SBP; the second while supine, after 30 min of rest. Parallel forms of the tests were presented on each testing session. Patients scored significantly worse in the visual search test, analogies test, immediate visual memory, and the measure of global cognitive functioning of Brief Mental Deterioration battery during the orthostatic challenge compared to the supine position. Orthostatic hypotension was associated with a significant worsening of cognitive performances, affecting both global cognitive functioning and specific tasks, mainly exploring executive functions. The assessment of cognitive function in patients with neurogenic orthostatic hypotension should be performed considering the body's position of the subject.

  4. Exosomes as novel regulators of adult neurogenic niches

    Directory of Open Access Journals (Sweden)

    Luis Federico Batiz

    2016-01-01

    Full Text Available Adult neurogenesis has been convincingly demonstrated in two regions of the mammalian brain: the sub-granular zone (SGZ of the dentate gyrus (DG in the hippocampus, and the sub-ventricular zone (SVZ of the lateral ventricles. SGZ newborn neurons are destined to the granular cell layer of the DG, while new neurons from the SVZ neurons migrate rostrally into the olfactory bulb. The process of adult neurogenesis persists throughout life and is supported by a pool of neural stem cells (NSCs, which reside in a unique and specialized microenvironment known as neurogenic niche. Neurogenic niches are structured by a complex organization of different cell types, including the NSC-neuron lineage, glial cells and vascular cells. Thus, cell-to-cell communication plays a key role in the dynamic modulation of homeostasis and plasticity of the adult neurogenic process. Specific cell-cell contacts and extracellular signals originated locally provide the necessary support and regulate the balance between self-renewal and differentiation of NSCs. Furthermore, extracellular signals originated at distant locations, including other brain regions or systemic organs, may reach the niche through the cerebrospinal fluid or the vasculature and influence its nature. The role of several secreted molecules, such as cytokines, growth factors, neurotransmitters, and hormones, in the biology of adult NSCs, has been systematically addressed. Interestingly, in addition to these well-recognized signals, a novel type of intercellular messengers has been identified recently: the extracellular vesicles (EVs. EVs, and particularly exosomes, are implicated in the transfer of mRNAs, microRNAs (miRNAs, proteins and lipids between cells and thus are able to modify the function of recipient cells. Exosomes appear to play a significant role in different stem cell niches such as the mesenchymal stem cell niche, cancer stem cell niche and pre-metastatic niche; however, their roles in adult

  5. Exosomes as Novel Regulators of Adult Neurogenic Niches

    Science.gov (United States)

    Bátiz, Luis Federico; Castro, Maite A.; Burgos, Patricia V.; Velásquez, Zahady D.; Muñoz, Rosa I.; Lafourcade, Carlos A.; Troncoso-Escudero, Paulina; Wyneken, Ursula

    2016-01-01

    Adult neurogenesis has been convincingly demonstrated in two regions of the mammalian brain: the sub-granular zone (SGZ) of the dentate gyrus (DG) in the hippocampus, and the sub-ventricular zone (SVZ) of the lateral ventricles (LV). SGZ newborn neurons are destined to the granular cell layer (GCL) of the DG, while new neurons from the SVZ neurons migrate rostrally into the olfactory bulb (OB). The process of adult neurogenesis persists throughout life and is supported by a pool of neural stem cells (NSCs), which reside in a unique and specialized microenvironment known as “neurogenic niche”. Neurogenic niches are structured by a complex organization of different cell types, including the NSC-neuron lineage, glial cells and vascular cells. Thus, cell-to-cell communication plays a key role in the dynamic modulation of homeostasis and plasticity of the adult neurogenic process. Specific cell-cell contacts and extracellular signals originated locally provide the necessary support and regulate the balance between self-renewal and differentiation of NSCs. Furthermore, extracellular signals originated at distant locations, including other brain regions or systemic organs, may reach the niche through the cerebrospinal fluid (CSF) or the vasculature and influence its nature. The role of several secreted molecules, such as cytokines, growth factors, neurotransmitters, and hormones, in the biology of adult NSCs, has been systematically addressed. Interestingly, in addition to these well-recognized signals, a novel type of intercellular messengers has been identified recently: the extracellular vesicles (EVs). EVs, and particularly exosomes, are implicated in the transfer of mRNAs, microRNAs (miRNAs), proteins and lipids between cells and thus are able to modify the function of recipient cells. Exosomes appear to play a significant role in different stem cell niches such as the mesenchymal stem cell niche, cancer stem cell niche and pre-metastatic niche; however, their

  6. DR diagnostic analysis of neuropathic arthropathy (charcot)%神经性关节病(charcot)的DR诊断分析

    Institute of Scientific and Technical Information of China (English)

    张健辉

    2012-01-01

      Objective To investigate the standard the DR chip for the diagnosis of neuropathic arthropathy. Colected from March 2010 to March 2012 15 cases of neuropathic joint disease DR images and diagnostic analysis. Results are confirmed by clinical, are neuropathic arthropathy. Conclusion DR check for neuropathic arthropathy convenience, you can make a clear diagnosis and differential diagnosis.%  目的探讨DR片对于神经性关节病的诊断标准。方法收集2010年3月至2012年3月15例神经性关节病DR图像及诊断进行分析。结果经临床证实,均为神经性关节病。结论 DR对于神经性关节病检查清晰方便,能做出较明确的诊断及鉴别诊断。

  7. Scoring haemophilic arthropathy on X-rays: improving inter- and intra-observer reliability and agreement using a consensus atlas

    International Nuclear Information System (INIS)

    The radiological Pettersson score (PS) is widely applied for classification of arthropathy to evaluate costly haemophilia treatment. This study aims to assess and improve inter- and intra-observer reliability and agreement of the PS. Two series of X-rays (bilateral elbows, knees, and ankles) of 10 haemophilia patients (120 joints) with haemophilic arthropathy were scored by three observers according to the PS (maximum score 13/joint). Subsequently, (dis-)agreement in scoring was discussed until consensus. Example images were collected in an atlas. Thereafter, second series of 120 joints were scored using the atlas. One observer rescored the second series after three months. Reliability was assessed by intraclass correlation coefficients (ICC), agreement by limits of agreement (LoA). Median Pettersson score at joint level (PSjoint) of affected joints was 6 (interquartile range 3-9). Using the consensus atlas, inter-observer reliability of the PSjoint improved significantly from 0.94 (95 % confidence interval (CI) 0.91-0.96) to 0.97 (CI 0.96-0.98). LoA improved from ±1.7 to ±1.1 for the PSjoint. Therefore, true differences in arthropathy were differences in the PSjoint of >2 points. Intra-observer reliability of the PSjoint was 0.98 (CI 0.97-0.98), intra-observer LoA were ±0.9 points. Reliability and agreement of the PS improved by using a consensus atlas. (orig.)

  8. Renal function in children with congenital neurogenic bladder

    Directory of Open Access Journals (Sweden)

    Karen Previdi Olandoski

    2011-01-01

    Full Text Available AIMS: Preservation of renal function in children with congenital neurogenic bladder is an important goal of treatment for the disease. This study analyzed the evolution of renal function in patients with congenital neurogenic bladder. METHODS: We reviewed the records of 58 pediatric patients with respect to the following attributes: gender, age, etiology of neurogenic bladder, reason for referral, medical/surgical management, episodes of treated urinary tract infections, urodynamics, DMSA scintigraphy, weight, height, blood pressure, glomerular filtration rate, microalbuminuria and metabolic acidosis. Statistical analysis was performed, adopting the 5% significance level. RESULTS: The mean age at presentation was 4.2 ± 3.5 years. Myelomeningocele was the most frequent etiology (71.4%. Recurrent urinary tract infection was the reason for referral in 82.8% of the patients. Recurrent urinary tract infections were diagnosed in 84.5% of the patients initially; 83.7% of those patients experienced improvement during follow-up. The initial mean glomerular filtration rate was 146.7 ± 70.1 mL/1.73 m²/min, and the final mean was 193.6 ± 93.6 mL/1.73 m²/min, p = 0.0004. Microalbuminuria was diagnosed in 54.1% of the patients initially and in 69% in the final evaluation. Metabolic acidosis was present in 19% of the patients initially and in 32.8% in the final assessment. CONCLUSIONS: Patient referral to a pediatric nephrologist was late. A reduction in the number of urinary tract infections was observed with adequate treatment, but microalbuminuria and metabolic acidosis occurred frequently despite adequate management.

  9. Neurogenic pulmonary edema in a child with status epilepticus

    Directory of Open Access Journals (Sweden)

    Bindu T Nair

    2016-01-01

    Full Text Available Neurogenic pulmonary edema (NPE is defined as acute pulmonary edema after a sudden neurologic insult. It develops after a significant central nervous system insult such as trauma, hemorrhage or seizures and can occur both in adults and children. A 6-year-old male child, known case of cerebral palsy was brought to the emergency department in status epilepticus. He had severe respiratory distress with pink frothy secretions pouring from the mouth. Clinical and radiological examination was suggestive of NPE. Child was immediately ventilated and all supportive measures were started. Child showed marked improvement within 48 h of admission with diuresis and positive end-expiratory pressure (PEEP assisted ventilation.

  10. Posterior mediastinal hemangioma mimicking neurogenic tumor: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Song, Han Byeoul; Park, Jong Chun [Dept. of Radiology, Daegu Catholic University Medical Center, Catholic University of Daegu College of Medicine, Daegu (Korea, Republic of)

    2015-07-15

    Mediastinal hemangioma is a benign vascular tumor and is located most frequently in the anterior mediastinum. Computed tomography showed a well-marginated central enhancing mass with extension into the adjacent foramen. The mass was relatively hyperintense to the skeletal muscle on T2-weighted image and on fat-saturated T1-weighted image with gadolinium enhancement. The tumor was confirmed to be a cavernous hemangioma by pathologic examination after surgery. The authors recently experienced a cavernous hemangioma in the posterior mediastinum. Thus, we report a case of a posterior mediastinal mass which was difficult to differentiate from a neurogenic tumor.

  11. From blood to brain: the neurogenic niche of the crayfish brain.

    Science.gov (United States)

    Hartenstein, Volker

    2014-08-11

    Adult neurogenic niches are present in both vertebrates and invertebrates. Where do stem cells populating these niches originate, and what are the mechanisms maintaining their self-renewal? In this issue of Developmental Cell, Benton et al. (2014) show that in crayfish, hemolymph-derived cells enter a neurogenic niche to replenish neural progenitors. PMID:25117680

  12. Quinolone arthropathy in immature rabbits treated with the fluoroquinolone, PD 117596.

    Science.gov (United States)

    Gough, A; Johnson, R; Campbell, E; Hall, L; Tylor, J; Carpenter, A; Black, W; Basrur, P K; Baragi, V M; Sigler, R; Metz, A

    1996-06-01

    To study the potential of the fluorquinolone, PD 117596 to cause arthropathy in experimental animals, immature rabbits were orally administered the drug for five days at 0, 100, 350, 500 and 750 mg/kg. Characterization of changes induced in major synovial joints was based on: macroscopic and histopathologic observations, transmission electron microscopic examinations and magnetic resonance imaging. Preferentially targeting the knee, PD 117596 produced vesicles and erosions in articular cartilage which resembled, morphologically, those described in other laboratory species. Lesion incidence was not clearly dose-related. In the perivesicular region, degenerate chondrocytes were intermixed with hypertrophic cartilage cells and chondrocyte clusters. Ultrastructurally, hypertrophic chondrocytes were the consequence of karyomegaly and RER proliferation. Matrix density was reduced due to collagen and proteoglycan loss. Joint structures were readily visualized by magnetic resonance imaging which identified thickened articular cartilage, surface irregularities consistent with ruptured vesicles and separation of opposing articular surfaces secondary to synovival effusions. The immature rabbit, although less sensitive than the juvenile dog to the arthropathic effects of quinolones, was nonetheless a good model to study this experimental osteoarticular disease.

  13. An ultrastructural and light microscopic study of the synovium in ochronotic arthropathy.

    Science.gov (United States)

    Gaines, J J; Tom, G D; Khankhanian, N

    1987-11-01

    The synovium in two well-documented cases of alkaptonuric ochronosis was studied by transmission electron and light microscopy. A feature of alkaptonuria previously unreported in the English-language literature was the presence of phagocytosis of large collagen fibrils by synovial macrophages in both cases. The origin of these fibrils appeared to have been shards of ochronotic cartilage and areas of metaplastic cartilage. This finding suggests that active remodeling of the synovial tissues occurs in advanced ochronotic arthropathy. Numerous shards of ochronotic cartilage were embedded in the synovium. In addition, small aggregates of large collagen fibrils encrusted with apparent ochronotic pigment were occasionally noted in the interstitium. These aggregates of ochronotic collagen are best described as microshards, and they have not generally been recognized in the literature. What appeared by light microscopy to represent ochronotic pigment deposition in interstitial collagen actually represented embedded microshards of ochronotic cartilage in the interstitium. Slender and elongated microshards were most likely to be confused by light microscopy as ochronotic interstitial collagen. PMID:3679190

  14. Bibliometric profile of neurogenic bladder in the literature: a 20-year bibliometric analysis

    Directory of Open Access Journals (Sweden)

    Yuan Gao

    2015-01-01

    Full Text Available Neurogenic bladder is a dysfunction of the lower urinary tract caused by nervous system disorder. We investigated the trends in publication of articles under the topic "neurogenic bladder" using bibliometric analysis. Articles on neurogenic bladder, published between 1995 and 2014, were retrieved from the ISI Web of Science citation database. We analyzed the search results for authors, countries, institutions, journals, and top-cited papers. A total of 1,904 articles were retrieved. There was a small increase in the number of articles on neurogenic bladder from 1995 (n = 43 to 2014 (n = 117. The USA was the leading country in the total number of articles (n = 598. However, the number of publications from China has rapidly increased, and China was ranked second in 2014. Emmanuel Chartier-Kastler (n = 65 was the most productive author, and University of Paris VI (Paris 6 (n = 61 was the most productive institution. The Journal of Urology published the greatest number of articles on this topic (n = 285. Articles on neurogenic bladder were often published in a professional journal under the category Urology & Nephrology, Neurosciences & Neurology, or Rehabilitation. Visualization analysis based on co-citation networks was conducted using CiteSpace III. Visualization analysis revealed that the hot spots in neurogenic bladder were botulinum toxin-A, prazosin, bethanechol, and afferent pathways. These findings provide new insight into the publication trends and hot spots in neurogenic bladder.

  15. Outcomes of bowel program in spinal cord injury patients with neurogenic bowel dysfunction

    Institute of Scientific and Technical Information of China (English)

    Zuhal Ozisler; Kurtulus Koklu; Sumru Ozel; Sibel Unsal-Delialioglu

    2015-01-01

    In this study, we aimed to determine gastrointestinal problems associated with neurogenic bowel dysfunction in spinal cord injury patients and to assess the efifcacy of bowel program on gas-trointestinal problems and the severity of neurogenic bowel dysfunction. Fifty-ifve spinal cord injury patients were included in this study. A bowel program according to the characteristics of neurogenic bowel dysfunction was performed for each patient. Before and after bowel program, gastrointestinal problems (constipation, dififcult intestinal evacuation, incontinence, abdominal pain, abdominal distension, loss of appetite, hemorrhoids, rectal bleeding and gastrointestinal induced autonomic dysrelfexia) and bowel evacuation methods (digital stimulation, oral med-ication, suppositories, abdominal massage, Valsalva maneuver and manual evacuation) were determined. Neurogenic bowel dysfunction score was used to assess the severity of neurogenic bowel dysfunction. At least one gastrointestinal problem was identiifed in 44 (80%) of the 55 patients before bowel program. Constipation (56%, 31/55) and incontinence (42%, 23/55) were the most common gastrointestinal problems. Digital rectal stimulation was the most common method for bowel evacuation, both before (76%, 42/55) and after (73%, 40/55) bowel program. Oral medication, enema and manual evacuation application rates were signiifcantly decreased and constipation, dififcult intestinal evacuation, abdominal distention, and abdominal pain rates were signiifcantly reduced after bowel program. In addition, mean neurogenic bowel dysfunction score was decreased after bowel program. An effective bowel program decreases the severity of neurogenic bowel dysfunction and reduces associated gastrointestinal problems in patients with spinal cord injury.

  16. Outcomes of bowel program in spinal cord injury patients with neurogenic bowel dysfunction

    Directory of Open Access Journals (Sweden)

    Zuhal Ozisler

    2015-01-01

    Full Text Available In this study, we aimed to determine gastrointestinal problems associated with neurogenic bowel dysfunction in spinal cord injury patients and to assess the efficacy of bowel program on gastrointestinal problems and the severity of neurogenic bowel dysfunction. Fifty-five spinal cord injury patients were included in this study. A bowel program according to the characteristics of neurogenic bowel dysfunction was performed for each patient. Before and after bowel program, gastrointestinal problems (constipation, difficult intestinal evacuation, incontinence, abdominal pain, abdominal distension, loss of appetite, hemorrhoids, rectal bleeding and gastrointestinal induced autonomic dysreflexia and bowel evacuation methods (digital stimulation, oral medication, suppositories, abdominal massage, Valsalva maneuver and manual evacuation were determined. Neurogenic bowel dysfunction score was used to assess the severity of neurogenic bowel dysfunction. At least one gastrointestinal problem was identified in 44 (80% of the 55 patients before bowel program. Constipation (56%, 31/55 and incontinence (42%, 23/55 were the most common gastrointestinal problems. Digital rectal stimulation was the most common method for bowel evacuation, both before (76%, 42/55 and after (73%, 40/55 bowel program. Oral medication, enema and manual evacuation application rates were significantly decreased and constipation, difficult intestinal evacuation, abdominal distention, and abdominal pain rates were significantly reduced after bowel program. In addition, mean neurogenic bowel dysfunction score was decreased after bowel program. An effective bowel program decreases the severity of neurogenic bowel dysfunction and reduces associated gastrointestinal problems in patients with spinal cord injury.

  17. Bibliometric profile of neurogenic bladder in the literature:a 20-year bibliometric analysis

    Institute of Scientific and Technical Information of China (English)

    Yuan Gao; Bo Qu; Yan Shen; Xiao-jing Su; Xiao-yan Dong; Xue-mei Chen; Yu-hong Zhou; Hong-ying Pi

    2015-01-01

    Neurogenic bladder is a dysfunction of the lower urinary tract caused by nervous system disor-der. We investigated the trends in publication of articles under the topic “neurogenic bladder”using bibliometric analysis. Articles on neurogenic bladder, published between 1995 and 2014, were retrieved from the ISI Web of Science citation database. We analyzed the search results for authors, countries, institutions, journals, and top-cited papers. A total of 1,904 articles were re-trieved. There was a small increase in the number of articles on neurogenic bladder from 1995 (n = 43) to 2014 (n = 117). The USA was the leading country in the total number of articles (n =598). However, the number of publications from China has rapidly increased, and China was ranked second in 2014. Emmanuel Chartier-Kastler (n = 65) was the most productive author, and University of Paris VI (Paris 6) (n = 61) was the most productive institution.The Journal of Urology published the greatest number of articles on this topic (n = 285). Articles on neurogenic bladder were often published in a professional journal under the category Urology & Nephrology, Neurosciences & Neurology, or Rehabilitation. Visualization analysis based on co-citation networks was conducted using CiteSpace III. Visualization analysis revealed that the hot spots in neurogenic bladder were botulinum toxin-A, prazosin, bethanechol, and afferent pathways. These findings provide new insight into the publication trends and hot spots in neurogenic bladder.

  18. Application of Cellular Technologies to the Experimental Treatment of Destructive Inflammatory Arthropathies

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    Marzhan Kaulambayeva

    2014-12-01

    Full Text Available Introduction. The treatment of destructive inflammatory joint diseases (arthropathies is one of the issues of current interest in modern medicine. In destructive inflammatory diseases, the regenerative ability of cartilaginous tissue proves to be inadequate for neogenesis of joints. The goal of this study is to determine the efficacy of bone marrow-derived mononuclear cell fraction (MNC and multipotent mesenchymal stromal cells (MMSC in the treatment of destructive inflammatory joint diseases.Materials and methods. The study subjects consisted of 15 male rabbits weighing 3-4 kg with experimental destructive inflammatory knee joint disease. The test animals were divided into 3 groups: reference group without treatment, first test group – introduction of autologous MNC from rabbit bone marrow into the affected joint, and second test group – introduction of cultured MMSC from rabbit bone marrow into the joint.Results. A morphological examination of the synovial membranes in the reference group on the 40th day of the experiment revealed chronic synovitis with destruction of synoviocytes, thickening and inflammatory infiltration of the underlying connective tissue (subintima. During examination of synovial membranes in the first test group the patches of thickened regenerating inner layer (intima made up by large proliferating synoviocytes were observed. The layer of loose connective tissue (subintima contained a large number of small blood vessels and was only slightly infiltrated by inflammatory cells. The morphological examination of synovial membranes in the second test group discovered thickened regenerating intimal layer sitting on hypertrophied subintima with dense vascular network. Elastic collagenous layers of synovial membrane adjoined proliferating elements in cartilage plates.Conclusion. Both autologous MNC fraction and MMSC from bone marrow proved effectiveness in the treatment of destructive inflammatory joint diseases which

  19. The arthropathy of systemic sclerosis: a 12 month prospective clinical and imaging study

    Energy Technology Data Exchange (ETDEWEB)

    Montagna, Giovanni La; Malesci, Domenico; Valentini, Gabriele [Seconda Universita di Napoli, Dipartimento Medico-Chirurgico di Internistica, Clinica e Sperimentale ' ' F Magrassi e A Lanzara' ' , Unita Operativa di Reumatologia, Naples (Italy); Sodano, Antonio; Capurro, Vittorio [Universita ' ' Federico II' ' , Dipartimento di Diagnostica per Immagini e Radioterapia, Naples (Italy)

    2005-01-01

    To assess the clinical and radiological features of systemic sclerosis (SSc) joint involvement in a prospective cross-sectional study. Seventy-six consecutive patients with SSc divided into clinical and serological subsets were investigated. Clinical and radiological assessments of the hands and feet were carried out. Three radiological patterns of inflammatory, degenerative and fibrotic changes were predefined. The Health Assessment Questionnaire (HAQ) disability index (DI) and individual components of the HAQ-DI were also evaluated. The highest impairments on the HAQ-DI (median 0.44; range 0-2.87) were detected in subdimensions such as hygiene, grip and activity components. Clinically articular involvement, arthralgia and finger contractures were seen more frequently than arthritis, and a significantly higher prevalence of finger flexion was found in patients with diffuse cutaneous SSc (P=0.03) compared with the other SSc subtypes. Radiologically, distal interphalangeal joint space narrowing and flexion deformity indicating periarticular fibrosis were frequently detected. Juxta-articular osteoporosis, joint space narrowing and flexion contractures of the fingers were seen significantly more frequently in the hands. A significantly higher frequency of fibrotic pattern were found in the hands whereas a degenerative pattern was more frequent in the feet (P<0.05). Finally, significant correlations were detected between flexion contractures and a radiological fibrotic pattern (P<0.001), and the severity scores of peripheral vascular impairment (P=0.026) and skin (P=0.007). This cross-sectional prospective study confirms that an arthropathy is common in SSc patients and shows that it is a major determinant of disability. A classification of radiological alterations into three specific patterns is proposed. (orig.)

  20. The arthropathy of systemic sclerosis: a 12 month prospective clinical and imaging study

    International Nuclear Information System (INIS)

    To assess the clinical and radiological features of systemic sclerosis (SSc) joint involvement in a prospective cross-sectional study. Seventy-six consecutive patients with SSc divided into clinical and serological subsets were investigated. Clinical and radiological assessments of the hands and feet were carried out. Three radiological patterns of inflammatory, degenerative and fibrotic changes were predefined. The Health Assessment Questionnaire (HAQ) disability index (DI) and individual components of the HAQ-DI were also evaluated. The highest impairments on the HAQ-DI (median 0.44; range 0-2.87) were detected in subdimensions such as hygiene, grip and activity components. Clinically articular involvement, arthralgia and finger contractures were seen more frequently than arthritis, and a significantly higher prevalence of finger flexion was found in patients with diffuse cutaneous SSc (P=0.03) compared with the other SSc subtypes. Radiologically, distal interphalangeal joint space narrowing and flexion deformity indicating periarticular fibrosis were frequently detected. Juxta-articular osteoporosis, joint space narrowing and flexion contractures of the fingers were seen significantly more frequently in the hands. A significantly higher frequency of fibrotic pattern were found in the hands whereas a degenerative pattern was more frequent in the feet (P<0.05). Finally, significant correlations were detected between flexion contractures and a radiological fibrotic pattern (P<0.001), and the severity scores of peripheral vascular impairment (P=0.026) and skin (P=0.007). This cross-sectional prospective study confirms that an arthropathy is common in SSc patients and shows that it is a major determinant of disability. A classification of radiological alterations into three specific patterns is proposed. (orig.)

  1. Sacral Fracture Causing Neurogenic Bladder: A Case Report

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    Tatsuro Sasaji

    2012-01-01

    Full Text Available A 76-year-old man presented with a Denis Zone III sacral fracture after a traffic accident. He also developed urinary retention and perineal numbness. The patient was diagnosed with neurogenic bladder dysfunction caused by the sacral fracture. A computed tomogram (CT revealed that third sacral lamina was fractured and displaced into the spinal canal, but vertebral body did not displace. The fracture lines began at the center of lamina and extended bilateraly. The fracture pattern was unique. The sacrum was osteoporosis, and this fracture may be based on osteoporosis. We performed laminectomy to decompress sacral nerve roots. One month after surgery, the patient was able to urinate. Three months after surgery, his bladder function recovered normally. One year after surgery, he returned to a normal daily life and had no complaints regarding urination. One-year postoperative CT showed the decompressed third sacrum without displacement.

  2. Neurogenic pulmonary edema in head injuries: analysis of 5 cases

    Institute of Scientific and Technical Information of China (English)

    QIN Shi-qiang; SUN Wei; WANG Han-bin; ZHANG Qing-lin

    2005-01-01

    Objective: To review the pathophysiology and study the diagnosis and clinical management of neurogenic pulmonary edema (NPE). Methods: The data of 5 patients who developed NPE after head injury treated in our hospital form December 1995 to May 2003 were collected and analyzed.Results: The patients developed dyspnea and respiratory failure 2-8 hours after neurologic event. Four of the 5 patients presented with pink frothy sputum. Chest radiography showed bilateral diffuse infiltrations in all the 5 patients. After supportive measures such as oxygen support and pharmacologic therapy, 4 patients recovered in 72 hours and one patient died. Conclusions: The pathophysiologic mechanisms of NPE is unclear. In acute respiratory failure following head injury, NPE must be given much attention and timely and effective measures should be taken.

  3. Scoring haemophilic arthropathy on X-rays: improving inter- and intra-observer reliability and agreement using a consensus atlas

    Energy Technology Data Exchange (ETDEWEB)

    Foppen, Wouter; Schaaf, Irene C. van der; Beek, Frederik J.A. [University Medical Center Utrecht, Department of Radiology (Netherlands); Verkooijen, Helena M. [University Medical Center Utrecht, Department of Radiology (Netherlands); University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht (Netherlands); Fischer, Kathelijn [University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht (Netherlands); University Medical Center Utrecht, Van Creveldkliniek, Department of Hematology, Utrecht (Netherlands)

    2016-06-15

    The radiological Pettersson score (PS) is widely applied for classification of arthropathy to evaluate costly haemophilia treatment. This study aims to assess and improve inter- and intra-observer reliability and agreement of the PS. Two series of X-rays (bilateral elbows, knees, and ankles) of 10 haemophilia patients (120 joints) with haemophilic arthropathy were scored by three observers according to the PS (maximum score 13/joint). Subsequently, (dis-)agreement in scoring was discussed until consensus. Example images were collected in an atlas. Thereafter, second series of 120 joints were scored using the atlas. One observer rescored the second series after three months. Reliability was assessed by intraclass correlation coefficients (ICC), agreement by limits of agreement (LoA). Median Pettersson score at joint level (PS{sub joint}) of affected joints was 6 (interquartile range 3-9). Using the consensus atlas, inter-observer reliability of the PS{sub joint} improved significantly from 0.94 (95 % confidence interval (CI) 0.91-0.96) to 0.97 (CI 0.96-0.98). LoA improved from ±1.7 to ±1.1 for the PS{sub joint}. Therefore, true differences in arthropathy were differences in the PS{sub joint} of >2 points. Intra-observer reliability of the PS{sub joint} was 0.98 (CI 0.97-0.98), intra-observer LoA were ±0.9 points. Reliability and agreement of the PS improved by using a consensus atlas. (orig.)

  4. Neurogenic Inflammation Involves in Systemic Spread of Oral Infection

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    Haryono Utomo

    2014-10-01

    Full Text Available Focal infection theory proposed in early 1900’s stated that dental infection caused systemic disorders. Nevertheless, the theory was abandoned since large number of teeth were extracted with no satisfying result. Recent reports revealed that oral infections were able to spread systemically. However, there is no rationalization available to explain how assisted drainage therapy (ADT, a periodontal therapy that could relief migraine and asthma within minutes. Oral neurogenic and immunogenic inflammation interaction involving pro-inflammatory markers such as calcitonin gene-related peptide (CGRP, TNF-α; and antiinflammatory vasoactive intestinal peptide (VIP was still under investigation. Objective: To verify the spread of oral inflammation to distant organ after performing ADT by analysing CGRP, VIP and TNF-α expressions. Methods: Two different concentration of Porphyromonas gingivalis lipopolysaccharide (PgLPS1435/1450 was injected intragingivally into two groups of 12 Wistar rats. After four days, 12 rats were given ADT and all samples were subsequently sacrificed 40 mins after ADT. Immunohistochemistry analysis using CGRP, VIP and TNF-α on the nasal and bronchus tissue was performed. ANOVA was used for statistical analyisis of the difference between CGRP, VIP and TNF-α expression between experimental groups. Results: PgLPS injections slightly increased CGRP, VIP and TNF-α expressions in the control group. Rats undergone ADT had lower CGRP and TNF-α but higher VIP expressions. Conclusion: Neurogenic inflammation involved in systemic spread of oral infection. ADT was able to downregulate inflammation in distant organ posibly by stimulating VIP.

  5. The Neurogenic Potential of Astrocytes Is Regulated by Inflammatory Signals.

    Science.gov (United States)

    Michelucci, Alessandro; Bithell, Angela; Burney, Matthew J; Johnston, Caroline E; Wong, Kee-Yew; Teng, Siaw-Wei; Desai, Jyaysi; Gumbleton, Nigel; Anderson, Gregory; Stanton, Lawrence W; Williams, Brenda P; Buckley, Noel J

    2016-08-01

    Although the adult brain contains neural stem cells (NSCs) that generate new neurons throughout life, these astrocyte-like populations are restricted to two discrete niches. Despite their terminally differentiated phenotype, adult parenchymal astrocytes can re-acquire NSC-like characteristics following injury, and as such, these 'reactive' astrocytes offer an alternative source of cells for central nervous system (CNS) repair following injury or disease. At present, the mechanisms that regulate the potential of different types of astrocytes are poorly understood. We used in vitro and ex vivo astrocytes to identify candidate pathways important for regulation of astrocyte potential. Using in vitro neural progenitor cell (NPC)-derived astrocytes, we found that exposure of more lineage-restricted astrocytes to either tumor necrosis factor alpha (TNF-α) (via nuclear factor-κB (NFκB)) or the bone morphogenetic protein (BMP) inhibitor, noggin, led to re-acquisition of NPC properties accompanied by transcriptomic and epigenetic changes consistent with a more neurogenic, NPC-like state. Comparative analyses of microarray data from in vitro-derived and ex vivo postnatal parenchymal astrocytes identified several common pathways and upstream regulators associated with inflammation (including transforming growth factor (TGF)-β1 and peroxisome proliferator-activated receptor gamma (PPARγ)) and cell cycle control (including TP53) as candidate regulators of astrocyte phenotype and potential. We propose that inflammatory signalling may control the normal, progressive restriction in potential of differentiating astrocytes as well as under reactive conditions and represent future targets for therapies to harness the latent neurogenic capacity of parenchymal astrocytes. PMID:26138449

  6. Neurogenic overactive bladder in spinal cord injury and multiple sclerosis: role of onabotulinumtoxinA

    OpenAIRE

    Ethans, Karen

    2014-01-01

    KD Ethans,1,2 AR Casey,1,2 RJ Bard,1,3 MP Namaka1 1University of Manitoba, 2Section of Physical Medicine and Rehabilitation, Health Sciences Centre, 3Section of Urology, Health Sciences Centre, Winnipeg, Manitoba, Canada Abstract: People with neurogenic overactive bladder from either multiple sclerosis or spinal cord injury often suffer significant morbidity and decreased quality of life. Here we review the pathophysiology of neurogenic overactive bladder and the impact it can have on people...

  7. Effectiveness of two modalities of physiotherapy in the treatment of haemophilic arthropathy of the ankle: a randomized pilot study.

    Science.gov (United States)

    Cuesta-Barriuso, R; Gómez-Conesa, A; López-Pina, J-A

    2014-01-01

    Although different techniques of physiotherapy have been described for the treatment of haemophilic arthropathy (HA) of ankle, hardly any studies have been applied manual therapy or educational physiotherapy and home exercises. The aim of this study was to assess the effectiveness of manual therapy and educational physiotherapy in the treatment of HA of the ankle. Thirty-one patients with HA of the ankle with a mean age of 35.29 (SD: 12.877) years randomized to manual therapy group (n = 11), educational group (n = 10) and a control group (n = 10). The two physiotherapy programmes were one with manual therapy articular traction, passive stretching of the gastrocnemius muscles, and exercises for muscle strength and proprioception (MT group) and the other with educational sessions and home exercises (E group). The study lasted for 12 weeks. The treatment with manual therapy improved the gastrocnemius muscle circumference, and the pain of ankle (P < 0.05). Six months later, MT group still enjoyed improvement. In the educational group there were improvements, but not significant, in the measured variables. No patient had ankle haemarthrosis during the study. The treatment with manual therapy improved the circumference of gastrocnemius and lessened pain in the patients with haemophilic arthropathy of the ankle.

  8. Effects of electrotherapy in treatment of neurogenic bladder in children with occult spinal dysraphism

    Directory of Open Access Journals (Sweden)

    Ćirović Dragana

    2009-01-01

    Full Text Available Introduction Neurogenic bladder can develop as a result of various degrees of neurogenic lesion in spina bifida. The degree of bladder dysfunction depends on the level and type of spina bifida. Due to results upon complete diagnostic protocols, treatment options are applied. Objective Comparison of therapy results of patients with occult spinal dysraphism with neurogenic bladder that under-went medicamentous therapy and medicamentous with electrotherapy treatment. Methods We had 49 patients with neurogenic bladder that were treated at the University Children's Hospital in Belgrade in the period 2003-2008. The first group of children received medicamentous therapy and the second group received medicamentous therapy with transcutaneous electric nerve stimulation. In both groups we evaluated 4 symptoms: daily enuresis, enuresis nocturna, urgency and frequency and 4 urodynamic parameters: lower bladder capacity, unstable contractions and residual urine and detrusor sphincter dyssynergia. Follow-up urodynamic evaluation was done after 3, 6 and 12 months respectively. Results Our findings pointed out a high statistical significance of improvement in all evaluated urodynamic parameters of neurogenic bladder (predominantly in bladder capacity in the group of children with combined therapy as well in resolution of symptoms (predominantly enuresis nocturna, urgency and frequency. Conclusion Combined therapy is more efficient in treatment of children with neurogenic bladder. Electrotherapy is non-invasive, easily applicable and has had a significant place in treatment of children with dysfunctional voiding.

  9. Synostosis Between Pubic Bones due to Neurogenic, Heterotopic Ossification

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    Subramanian Vaidyanathan

    2006-01-01

    Full Text Available Neurogenic, heterotopic ossification is characterised by the formation of new, extraosseous (ectopic bone in soft tissue in patients with neurological disorders. A 33-year-old female, who was born with spina bifida, paraplegia, and diastasis of symphysis pubis, had indwelling urethral catheter drainage and was using oxybutynin bladder instillations. She was prescribed diuretic for swelling of feet, which aggravated bypassing of catheter. Hence, suprapubic cystostomy was performed. Despite anticholinergic therapy, there was chronic urine leak around the suprapubic catheter and per urethra. Therefore, the urethra was mobilised and closed. After closure of the urethra, there was no urine leak from the urethra, but urine leak persisted around the suprapubic catheter. Cystogram confirmed the presence of a Foley balloon inside the bladder; there was no urinary fistula. The Foley balloon ruptured frequently, leading to extrusion of the Foley catheter. X-ray of abdomen showed heterotopic bone formation bridging the gap across diastasis of symphysis pubis. CT of pelvis revealed heterotopic bone lying in close proximity to the balloon of the Foley catheter; the sharp edge of heterotopic bone probably acted like a saw and led to frequent rupture of the balloon of the Foley catheter. Unique features of this case are: (1 temporal relationship of heterotopic bone formation to suprapubic cystostomy and chronic urine leak; (2 occurrence of heterotopic ossification in pubic region; (3 complications of heterotopic bone formation viz. frequent rupture of the balloon of the Foley catheter by the irregular margin of heterotopic bone and difficulty in insertion of suprapubic catheter because the heterotopic bone encroached on the suprapubic track; (4 synostosis between pubic bones as a result of heterotopic ossification..Common aetiological factors for neurogenic, heterotopic ossification, such as forceful manipulation, trauma, or spasticity, were absent in this

  10. Intracellular and extracellular CPPD crystals are a regular feature in synovial fluid from uninflamed joints of patients with CPPD related arthropathy

    OpenAIRE

    Martinez, S.; Pascual, E.

    2005-01-01

    Objectives: To determine whether calcium pyrophosphate dihydrate (CPPD) crystals can be found in the synovial fluid of non-inflamed joints in patients with CPPD related arthropathy; if so, to determine whether they interact with cells and produce subclinical inflammation in this setting.

  11. Neurogenic heterotopic ossification : a diagnostic and therapeutic challenge in neurorehabilitation.

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    Taly A

    2001-01-01

    Full Text Available Heterotopic ossification (HO is an important cause of restriction in range of movements and secondary motor disability following neurotrauma, orthopaedic interventions and burns. It has not received focussed attention in non-traumatic neurological disorders. In a prospective study of 377 patients, on medical problems in neurological rehabilitation setting, 15 subjects (3.97% had neurogenic heterotopic ossification. Their clinical diagnosis was: transverse myelitis (7, neurotuberculosis (4, traumatic myelopathy (2 and stroke (2. Hip (10, knee (4 and elbow joints (1 were involved. The risk factors included urinary tract infection (15, spasticity (6, pressure sores (13 and deep venous thrombosis (DVT (6. The initial diagnosis was often other than HO and included DVT (3, haematoma (2 and arthritis (2. ESR and serum alkaline phosphatase levels were elevated in all but one subject. The diagnosis of HO was established using X-rays, CT Scan and three-phase bone scan. Following treatment with non-steroidal anti-inflammatory drugs, the range of motion improved in only four patients. HO resulted in significant loss of therapy time during rehabilitation. High index of suspicion about this complication is necessary for early diagnosis and prompt intervention.

  12. Thoraco-retroperitoneal neurogenic tumors. Report of two cases

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    C.E. Roată

    2013-09-01

    Full Text Available Retroperitoneal and posterior thoracic neurogenic tumors are rare tumors and may have different origins: ganglion cell (ganglioneuromas, ganglioneuroblastomas, neuroblastomas, paraganglionic system (paragangliomas, pheochromocytomas and nerve sheath (schwannomas, neurofibromas, malignant nerve sheath tumors. Nerve sheath tumors are mostly benign tumors. These tumors usually present late and cause symptoms or become palpable once they have reached a significant size. Good quality cross-sectional imaging is necessary to evaluate these types of tumors and the diagnosis may be suggested by the imaging appearance of the lesion, including its location, shape, and internal structure. Distinguish between benign and malignant tumors is difficult to make preoperatively unless distant metastases are present. A core needle biopsy may be helpful but tumor location and its frequently encountered close relations with vascular structures preclude it. Surgery remains the mainstay of curative therapy for these tumors. We present two cases, a retroperitoneal benign schwannoma and a posterior thoracic malignant nerve sheath tumor with retroperitoneal extension, which were successfully resected through an abdominal approach and phrenotomy. Preoperative imaging, surgical approach and intraoperative strategy are emphasized

  13. Preventing kidney injury in children with neurogenic bladder dysfunction.

    Science.gov (United States)

    Larijani, Faezeh Javadi; Moghtaderi, Mastaneh; Hajizadeh, Nilofar; Assadi, Farahnak

    2013-12-01

    The most common cause of neurogenic bladder dysfunction (NBD) in newborn infants is myelomeningocele. The pathophysiology almost always involves the bladder detrusor sphincter dyssynergy (DSD), which if untreated can cause severe and irreversible damage to the upper and lower urinary tracts. Early diagnosis and adequate management of NBD is critical to prevent both renal damage and bladder dysfunction and to reduce chances for the future surgeries. Initial investigation of the affected newborn infant includes a renal and bladder ultrasound, measurement of urine residual, determination of serum creatinine level, and urodynamics study. Voiding cystogram is indicated when either hydronephrosis or DSD is present. The main goal of treatment is prevention of urinary tract deterioration and achievement of continuance at an appropriate age. Clean intermittent catheterization (CIC) in combination with anticholinergic (oxybutynin) and antibiotics are instituted in those with high filling and voiding pressures, DSD and/or high grade reflux immediately after the myelomeningocele is repaired. Botulium toxin-A injection into detrusor is a safe alternative in patients with insufficient response or significant side effects to anticholinergic (oral or intravesical instillation) therapy. Surgery is an effective alternative in patients with persistent detrusor hyperactivity and/or dyssynergic detrusor sphincter despites of the CIC and maximum dosage of anticholinergic therapy. Children with NBD require care from a multidisciplinary team approach consisting of pediatricians, neurosurgeon, urologist, nephrologists, orthopedic surgeon, and other allied medical specialists. PMID:24498490

  14. Preventing kidney injury in children with neurogenic bladder dysfunction

    Directory of Open Access Journals (Sweden)

    Faezeh Javadi Larijani

    2013-01-01

    Full Text Available The most common cause of neurogenic bladder dysfunction (NBD in newborn infants is myelomeningocele. The pathophysiology almost always involves the bladder detrusor sphincter dyssynergy (DSD, which if untreated can cause severe and irreversible damage to the upper and lower urinary tracts. Early diagnosis and adequate management of NBD is critical to prevent both renal damage and bladder dysfunction and to reduce chances for the future surgeries. Initial investigation of the affected newborn infant includes a renal and bladder ultrasound, measurement of urine residual, determination of serum creatinine level, and urodynamics study. Voiding cystogram is indicated when either hydronephrosis or DSD is present. The main goal of treatment is prevention of urinary tract deterioration and achievement of continuance at an appropriate age. Clean intermittent catheterization (CIC in combination with anticholinergic (oxybutynin and antibiotics are instituted in those with high filling and voiding pressures, DSD and/or high grade reflux immediately after the myelomeningocele is repaired. Botulium toxin-A injection into detrusor is a safe alternative in patients with insufficient response or significant side effects to anticholinergic (oral or intravesical instillation therapy. Surgery is an effective alternative in patients with persistent detrusor hyperactivity and/or dyssynergic detrusor sphincter despites of the CIC and maximum dosage of anticholinergic therapy. Children with NBD require care from a multidisciplinary team approach consisting of pediatricians, neurosurgeon, urologist, nephrologists, orthopedic surgeon, and other allied medical specialists.

  15. Neuropathic arthropathy caused by Chiari malformation%Chiari畸形合并神经性关节病38例临床分析

    Institute of Scientific and Technical Information of China (English)

    谷重山; 王振宇; 马长城

    2010-01-01

    Objective To discuss the relative pathogenic factors and mechanisms of neuropathic arthropathy caused by Chiari malformation. Method 309 cases with Chiari malformation in the third hospital of Peking University from 1998 to 2008 were reviewed, and there were 38 cases with neuropathic arthropathy. The general conditions, affected joints, clinical manifestation, radiology and operations were summarized. Results There were remarkable relationship between course of disease, upper limb muscle atrophy and neuropathic arthropathy. After the operations of occipital - cervical decompression or syrinx shunting,18 patients improved in arthropathy. Conclusions Patients with atrophy of upper limb muscles may be prone to neuropathic arthropathy. At the same time, the course of disease is another risk factor. Treatment includes operations on primary diseases,functional exercise of affected joints and drug therapy.%目的 探讨Chiari畸形合并神经性关节病的相关因素和发病机制.方法 回顾性分析38例Chiari畸形合并神经性关节病患者的临床资料,总结其发病特点、发病部位、临床表现、影像学表现和手术治疗等情况.结果 病程长短、上肢肌肉是否萎缩与神经性关节病的发生有关.经枕颈减压术或空洞分流术治疗后,18例患者关节症状改善.结论 上肢肌肉萎缩和病程较长是神经性关节病的危险因素.治疗上以手术治疗原发病为主,辅以关节局部功能锻炼和药物治疗.

  16. Risk factors of adverse drug reaction from non-steroidal anti-inflammatory drugs in Shanghai patients with arthropathy

    Institute of Scientific and Technical Information of China (English)

    Wen SHI; Yong-ming WANG; Shao-li LI; Min YAN; Duan Li; Bin-yah CHEN; Neng-neng CHENG

    2004-01-01

    AIM: The study was to screen the possible risk factors of adverse drug reaction (ADR) induced by non-steroidal anti-inflammatory drugs (NSAIDs) in Shanghai patients with arthropathy. METHODS: The subjects were randomly selected from a database of outpatients with arthropathy from 9 main hospitals in Shanghai. A door to door retrospective epidemiological survey was used to collect demographic information about the patients, both individual and familial. This included data on their medical histories, lifestyle and dietary habits, history of smoking and alcohol consumption, history of drug therapy, quality of life (QOL) prior to NSAIDs intake, history of NSAIDs therapy and its ADR events, etc. Descriptive statistical methods and univariate analysis were also used to identify possible risk factors for ADRs induced by NSAIDs. RESULTS: Of the 1002 patients surveyed, the average length of NSAIDs intake was 2 years. ADR incidence from different NSAIDs was high, in a range from 46.7 %-66.2 %.In general, the candidate risk factors for ADRs were different for each NSAID. Each of the candidate risk factors were defined and studied in order to evaluate its role in the determination of ADRs from NSAIDs. "Family history of ADRs caused by NSAIDs" was found to be a significant risk factor for the four commonly used NSAIDs:meloxicam, diclofenac, nimesulide, and nabumetone. CONCLUSION: A retrospective epidemiological survey was useful in detecting the risk factors for ADRs caused by NSAIDs. The study found that different NSAIDs might have different risk factors and that there is no single risk factor universally applicable to all NSAIDs.

  17. Urodynamic and physiologic patterns associated with the common causes of neurogenic bladder in adults.

    Science.gov (United States)

    Allio, Bryce Andrew; Peterson, Andrew Charles

    2016-02-01

    The clinical presentation of the neurogenic bladder can be as vast as the pathologic causes however urodynamics (UDS) can help guide clinical decision-making and help simplify a complex disease state. UDS may be considered as the gold standard in helping to break down complex and multifactorial voiding dysfunction into manageable goals; these include protecting the upper tracts, limiting urinary tract infections (UTI) via avoiding urinary stasis, and maintaining quality of life. Included within are examples of normal to pathologic tracings including normal filling and voiding, detrusor sphincteric coordination, changes in compliance, etc. Additionally we have provided expected UDS findings based on neurogenic disease process, including but not limited to, Parkinson's, dementia, multiple sclerosis (MS) and spinal cord injury based on lesion location. Pattern recognition and understanding of UDS can help lead to quality of life improvements and optimal management for the patient with neurogenic bladder dysfunction. PMID:26904410

  18. Detrusor Arreflexia as an End Stage of Neurogenic Bladder in HAM/TSP?

    Directory of Open Access Journals (Sweden)

    Matheus Tannus

    2011-01-01

    Full Text Available The HTLV-1 virus is a known agent involved in the development of HAM/TSP. Past studies have typically observed patients with autonomic dysfunction consisting of detrusor overactivity and detrusor-sphincter dyssynergia, with the occasional observation of underactive detrusor or detrusor arreflexia. However, studies have not yet evaluated the progression of neurogenic bladder over time. In this paper, we describe a HAM/TSP patient with the initial development of overactive detrusor, and subsequent development of detrusor arreflexia. Given a paucity of studies characterizing the effects of HTLV-1 on the autonomic nervous system, particularly aspects controlling continence, this patient's clinical course may represent one type of end point for patients with HAM/TSP and neurogenic bladder. Further cohort or case-series studies, with particular emphasis on the progression of neurogenic bladder, are needed to evaluate the significance of this described case in relation to typical disease progression patterns.

  19. Ventral midbrain neural stem cells have delayed neurogenic potential in vitro.

    Science.gov (United States)

    Hegarty, Shane V; Spitere, Katie; Sullivan, Aideen M; O'Keeffe, Gerard W

    2014-01-24

    Neural stem cells (NSCs) have been the focus of an intensive effort to direct their differentiation in vitro towards desired neuronal phenotypes for cell replacement therapies. It is thought that NSCs derived from older embryos have limited neurogenic capacity and are restricted towards an astroglial fate. This idea is largely based on studies that typically analysed NSC-derived progeny following one week of in vitro differentiation. In this report, the neurogenic capacity of older ventral midbrain (VM) NSCs was assessed. When the older NSCs were differentiated for three weeks, there were significant increases in the numbers of newly born neurons at 14 and 21 days, as assessed by 5-bromo-2'-deoxyuridine (BrdU) incorporation. Therefore this study demonstrates that older NSCs retain significantly more neurogenic potential than was previously thought. These data have implications for NSC preparatory protocols and the choice of donor age for cell transplantation studies, and contributes to the understanding of NSC behaviour in vitro.

  20. Congenital neurogenic muscular atrophy in megaconial myopathy due to a mutation in CHKB gene.

    Science.gov (United States)

    Castro-Gago, Manuel; Dacruz-Alvarez, David; Pintos-Martínez, Elena; Beiras-Iglesias, Andrés; Arenas, Joaquín; Martín, Miguel Ángel; Martínez-Azorín, Francisco

    2016-01-01

    Choline kinase beta gene (CHKB) mutations have been identified in Megaconial Congenital Muscular Dystrophy (MDCMC) patients, a very rare inborn error of metabolism with 21 cases reported worldwide. We report the case of a Spanish boy of Caucasian origin who presented a generalized congenital muscular hypotonia, more intense at lower limb muscles, mildly elevated creatine kinase (CK), serum aspartate transaminase (AST) and lactate. Electromyography (EMG) showed neurogenic potentials in the proximal muscles. Histological studies of a muscle biopsy showed neurogenic atrophy with enlarged mitochondria in the periphery of the fibers, and complex I deficiency. Finally, genetic analysis showed the presence of a homozygous mutation in the gene for choline kinase beta (CHKB: NM_005198.4:c.810T>A, p.Tyr270(∗)). We describe here the second Spanish patient whit mutation in CHKB gene, who despite having the same mutation, presented an atypical aspect: congenital neurogenic muscular atrophy progressing to a combined neuropathic and myopathic phenotype (mixed pattern).

  1. The effect of penile vibratory stimulation on male fertility potential, spasticity and neurogenic detrusor overactivity in spinal cord lesioned individuals

    DEFF Research Database (Denmark)

    Biering-Sørensen, F; Læssøe, Line; Sønksen, J;

    2005-01-01

    Present the possibility for treatment of male infertility, spasticity, and neurogenic detrusor overactivity in spinal cord lesioned (SCL) individuals with penile vibratory stimulation (PVS).......Present the possibility for treatment of male infertility, spasticity, and neurogenic detrusor overactivity in spinal cord lesioned (SCL) individuals with penile vibratory stimulation (PVS)....

  2. Botulinum toxin A for treatment of neurogenic detrusor overactivity and incontinence in patients with spinal cord lesions

    DEFF Research Database (Denmark)

    Bagi, Per; Biering-Sørensen, Fin

    2004-01-01

    To evaluate the efficacy of intravesical botulinum toxin A (BTA) in the treatment of severe neurogenic detrusor overactivity (NDO) with incontinence in patients with spinal cord lesions (SCLs).......To evaluate the efficacy of intravesical botulinum toxin A (BTA) in the treatment of severe neurogenic detrusor overactivity (NDO) with incontinence in patients with spinal cord lesions (SCLs)....

  3. Intravesical prostatic protrusion correlates well with storage symptoms in elderly male patients with non-neurogenic overactive bladder

    Directory of Open Access Journals (Sweden)

    Shih-Yen Lu

    2016-03-01

    Conclusion: In elderly male patients with non-neurogenic OAB, more severe storage symptoms are associated with a lower maximum flow rate and a more prominent IPP, indicating that a significant cause of male non-neurogenic OAB is prostate associated.

  4. Characterization of multiciliated ependymal cells that emerge in the neurogenic niche of the aged zebrafish brain.

    Science.gov (United States)

    Ogino, Takashi; Sawada, Masato; Takase, Hiroshi; Nakai, Chiemi; Herranz-Pérez, Vicente; Cebrián-Silla, Arantxa; Kaneko, Naoko; García-Verdugo, José Manuel; Sawamoto, Kazunobu

    2016-10-15

    In mammals, ventricular walls of the developing brain maintain a neurogenic niche, in which radial glial cells act as neural stem cells (NSCs) and generate new neurons in the embryo. In the adult brain, the neurogenic niche is maintained in the ventricular-subventricular zone (V-SVZ) of the lateral wall of lateral ventricles and the hippocampal dentate gyrus. In the neonatal V-SVZ, radial glial cells transform into astrocytic postnatal NSCs and multiciliated ependymal cells. On the other hand, in zebrafish, radial glial cells continue to cover the surface of the adult telencephalic ventricle and maintain a higher neurogenic potential in the adult brain. However, the cell composition of the neurogenic niche of the aged zebrafish brain has not been investigated. Here we show that multiciliated ependymal cells emerge in the neurogenic niche of the aged zebrafish telencephalon. These multiciliated cells appear predominantly in the dorsal part of the ventral telencephalic ventricular zone, which also contains clusters of migrating new neurons. Scanning electron microscopy and live imaging analyses indicated that these multiple cilia beat coordinately and generate constant fluid flow within the ventral telencephalic ventricle. Analysis of the cell composition by transmission electron microscopy revealed that the neurogenic niche in the aged zebrafish contains different types of cells, with ultrastructures similar to those of ependymal cells, transit-amplifying cells, and migrating new neurons in postnatal mice. These data suggest that the transformation capacity of radial glial cells is conserved but that its timing is different between fish and mice. J. Comp. Neurol. 524:2982-2992, 2016. © 2016 Wiley Periodicals, Inc. PMID:26991819

  5. The conceptualization and development of a patient-reported neurogenic bladder symptom score

    Directory of Open Access Journals (Sweden)

    Welk B

    2013-10-01

    Full Text Available Blayne Welk,1 Sarah A Morrow,2 Wendy Madarasz,3 Patrick Potter,4 Keith Sequeira41Department of Surgery, Division of Urology, 2Department of Clinical Neurosciences, Western University, London, ON, Canada; 3St Joseph's Health Care, London Ontario, Canada; 4Department of Physical Medicine and Rehabilitation, Western University, London, ON, CanadaBackground: There is no single patient-reported instrument that was developed specifically to assess symptoms and bladder-related consequences for neurogenic bladder dysfunction. The purpose of this study was to identify and consolidate items for a novel measurement tool for this population.Methods: Item generation was based on a literature review of existing instruments, open-ended semistructured interviews with patients, and expert opinion. Judgment-based item reduction was performed by a multidisciplinary expert group. The proposed questionnaire was sent to external experts for review.Results: Eight neurogenic quality of life measures and 29 urinary symptom-specific instruments were identified. From these, 266 relevant items were extracted and used in the creation of the new neurogenic symptom score. Qualitative interviews with 16 adult patients with neurogenic bladder dysfunction as a result of spinal cord injury, multiple sclerosis, or spina bifida were completed. Dominant themes included urinary incontinence, urinary tract infections, urgency, and bladder spasms. Using the literature review and interview data, 25 proposed items were reviewed by 12 external experts, and the questions evaluated based on importance on a scale of 1 (not important to 5 (very important. Retained question domains had high mean importance ratings of 3.1 to 4.3 and good agreement with answer hierarchy.Conclusion: The proposed neurogenic bladder symptom score is a novel patient-reported outcome measure. Further work is underway to perform a data-based item reduction and to assess the validity and reliability of this instrument

  6. Development and definition of a simplified scanning procedure and scoring method for Haemophilia Early Arthropathy Detection with Ultrasound (HEAD-US).

    Science.gov (United States)

    Martinoli, Carlo; Della Casa Alberighi, Ornella; Di Minno, Giovanni; Graziano, Ermelinda; Molinari, Angelo Claudio; Pasta, Gianluigi; Russo, Giuseppe; Santagostino, Elena; Tagliaferri, Annarita; Tagliafico, Alberto; Morfini, Massimo

    2013-06-01

    The aim of this study was to develop a simplified ultrasound scanning procedure and scoring method, named Haemophilia Early Arthropathy Detection with UltraSound [HEAD-US], to evaluate joints of patients with haemophilic arthropathy. After an initial consensus-based process involving a multidisciplinary panel of experts, three comprehensive and evidence-based US scanning procedures to image the elbow, knee and ankle were established with the aim to increase sensitivity in detection of early signs of joint involvement while keeping the technique easy and quick to perform. Each procedure included systematic evaluation of synovial recesses and selection of a single osteochondral surface for damage analysis. Based on expert consensus, a simplified scoring system based on an additive scale was created to define the joint status and, in perspective, to offer a tool to evaluate disease progression and monitor the result of treatment in follow-up studies.

  7. A Clinician Survey of Speech and Non-Speech Characteristics of Neurogenic Stuttering

    Science.gov (United States)

    Theys, Catherine; van Wieringen, Astrid; De Nil, Luc F.

    2008-01-01

    This study presents survey data on 58 Dutch-speaking patients with neurogenic stuttering following various neurological injuries. Stroke was the most prevalent cause of stuttering in our patients, followed by traumatic brain injury, neurodegenerative diseases, and other causes. Speech and non-speech characteristics were analyzed separately for…

  8. Neurogenic pulmonary edema due to ventriculo-atrial shunt dysfunction: a case report

    Directory of Open Access Journals (Sweden)

    Ana Sofia Cruz

    2016-04-01

    Full Text Available ABSTRACT BACKGROUND AND OBJECTIVES: Pulmonary edema is caused by the accumulation of fluid within the air spaces and the interstitium of the lung. Neurogenic pulmonary edema is a clinical syndrome characterized by the acute onset of pulmonary edema following a significant central nervous system insult. It may be a less-recognized consequence of raised intracranial pressure due to obstructive hydrocephalus by blocked ventricular shunts. It usually appears within minutes to hours after the injury and has a high mortality rate if not recognized and treated appropriately. CASE REPORT: We report a patient with acute obstructive hydrocephalus due to ventriculo-atrial shunt dysfunction, proposed to urgent surgery for placement of external ventricular drainage, who presented with neurogenic pulmonary edema preoperatively. She was anesthetized and supportive treatment was instituted. At the end of the procedure the patient showed no clinical signs of respiratory distress, as prompt reduction in intracranial pressure facilitated the regression of the pulmonary edema. CONCLUSIONS: This report addresses the importance of recognition of neurogenic pulmonary edema as a possible perioperative complication resulting from an increase in intracranial pressure. If not recognized and treated appropriately, neurogenic pulmonary edema can lead to acute cardiopulmonary failure with global hypoperfusion and hypoxia. Therefore, awareness of and knowledge about the occurrence, clinical presentation and treatment are essential.

  9. Onabotulinum toxin a (botox®) in the treatment of neurogenic bladder overactivity

    DEFF Research Database (Denmark)

    Rohrsted, Malene; Nordsten, Cecilie Bagi; Bagi, Per

    2012-01-01

    on a systematic search of the PubMed database, a review of the current literature on the use of onabotulinum toxin A (Botox®) in the treatment of neurogenic detrusor overactivity is presented. Onabotulinum toxin A proved to be highly effective in the majority of studies, even though a wide range of injection...

  10. Leiomyosarcoma of the Oropharynx and Neurogenic Tumors in a YoungPatient With Turner's Syndrome

    OpenAIRE

    Annamaria Borghese; Vito Ninfo; Vincenzo De Rosa; Francesco Ionna; Gerardo Botti; Simona Losito; Giustino Silvestro; Gaetano Apice; Annarosaria De Chiara

    2001-01-01

    Patient: A case of Turner's syndrome developing a leiomyosarcoma of the oropharynx and metachronous neurogenic tumors (mediastinal ‘ganglioneuroblastoma intermixed’, subcutaneous neurilemoma) is described. Discussion: To our knowledge, this case is the second reported leiomyosarcoma in a patient with Turner's syndrome. Also the site of involvement (palate and oropharynx) is particularly unusual for the already rare leiomyosarcomas in the young age.

  11. Neurogenic Language Disorders in Children. International Association of Logopedics and Phoniatrics

    Science.gov (United States)

    Fabbro, Franco, Ed.

    2004-01-01

    Language disorders in children are one of the most frequent causes of difficulties in communication, social interaction, learning and academic achievement. It has been estimated that over 5% of children present with some kind of language disorder. This volume illustrates the state of the art in neurogenic language disorders in children. The most…

  12. Neurogenética en el Perú, ejemplo de investigación traslacional

    Directory of Open Access Journals (Sweden)

    Pilar Mazzetti

    2015-10-01

    Full Text Available La neurogenética es una disciplina emergente en el Perú que vincula la investigación básica con la práctica clínica. El Centro de Investigación Básica en Neurogenética, es el único centro en el Perú dedicado a la atención especializada de enfermedades neurogenéticas. La investigación en esta área está estrechamente ligada a la enfermedad de Huntington, desde la genotipificación del gen HTT por PCR, hasta los actuales estudios de haplogrupos en esta enfermedad. La investigación en otras enfermedades monogénicas permitió la implementación de metodologías alternativas para la genotipificación del síndrome X frágil y distrofia miotónica tipo 1. Esfuerzos colaborativos nacionales e internacionales han permitido conocer nuevas variantes genéticas en enfermedades complejas, como la enfermedad de Parkinson y Alzheimer. El entrenamiento multidisciplinario y la mentoría fomentan la formación de nuevos especialistas en neurogenética, permitiendo el crecimiento sostenido de esta disciplina en el país. El impulso de la investigación en el Perú ha impulsado el crecimiento de la investigación en neurogenética; sin embargo, las limitaciones en infraestructura, tecnología y capacitación aún son un reto para el crecimiento de investigación en esta disciplina

  13. Neurogenic bladder following myelopathies: Has it any correlation with neurological and functional recovery?

    Directory of Open Access Journals (Sweden)

    Nitin Menon

    2014-01-01

    Full Text Available Objectives: To observe neurogenic bladder pattern in patients with myelopathy by performing urodynamic study (UDS and to observe whether it has any correlation with functional and neurological recovery. Patients and Methods: This prospective study was conducted with 90 patients with myelopathy, both traumatic and non-traumatic (males = 65 in a university tertiary research hospital in India between January 2011 and December 2013. Mean age was 33.5 ± 13.2 years (range 15-65 years, mean duration of injury was 82.63 ± 88.3 days (range 14-365 days and mean length of stay (LOS in the rehabilitation unit 42.5 ± 23.3 days (range 14-130 days. The urodynamic study was performed in all the patients to assess the neurogenic bladder pattern. Management was based on the UDS findings. Functional recovery was assessed using Barthel index (BI scores and spinal cord independence measures (SCIM scores. Neurological recovery was assessed using ASIA impairment scale (AIS. We tried to correlate neurogenic bladder patterns with recovery. Results: Fifty patients (55.6% had overactive detrusor with 25 each had detrusor sphincter dyssynergia (DSD and synergic sphincter. Thirty-eight patients had hypoactive/acontractile detrusor and two had normal studies. No significant correlation observed between neurogenic bladder pattern and change in BI scores (P = 0.696, SCIM scores (P = 0.135 or change in ASIA status (P = 0.841 in the study. Conclusions: More than half of the patients with myelopathies had overactive detrusor with or without dyssynergic sphincter according to the urodynamic study. Neurogenic bladder patterns had no significant correlation with functional and neurological recovery in these patients.

  14. Neurogenética en el Perú, ejemplo de investigación traslacional

    Directory of Open Access Journals (Sweden)

    Pilar Mazzetti

    2015-12-01

    Full Text Available La neurogenética es una disciplina emergente en el Perú que vincula la investigación básica con la práctica clínica. El Centro de Investigación Básica en Neurogenética, es el único centro en el Perú dedicado a la atención especializada de enfermedades neurogenéticas. La investigación en esta área está estrechamente ligada a la enfermedad de Huntington, desde la genotipificación del gen HTT por PCR, hasta los actuales estudios de haplogrupos en esta enfermedad. La investigación en otras enfermedades monogénicas permitió la implementación de metodologías alternativas para la genotipificación del síndrome X frágil y distrofia miotónica tipo 1. Esfuerzos colaborativos nacionales e internacionales han permitido conocer nuevas variantes genéticas en enfermedades complejas, como la enfermedad de Parkinson y Alzheimer. El entrenamiento multidisciplinario y la mentoría fomentan la formación de nuevos especialistas en neurogenética, permitiendo el crecimiento sostenido de esta disciplina en el país. El impulso de la investigación en el Perú ha impulsado el crecimiento de la investigación en neurogenética; sin embargo, las limitaciones en infraestructura, tecnología y capacitación aún son un reto para el crecimiento de investigación en esta disciplina

  15. MRI对脊髓空洞症合并夏科氏关节病的诊断价值%MRI diagnosis of Charcot arthropathy caused by syringomyelia

    Institute of Scientific and Technical Information of China (English)

    邵硕; 齐先龙; 郑宁; 孟强

    2016-01-01

    Objective To explore the clinical value of MRI diagnosis of Charcot arthropathy caused by syringomyelia , in order to improve the recognition of the disease .Methods 5 patients with Charcot arthropathy caused by syringomyelia were included in this study.All patients underwent MRI examination .Results Three cases of shoulder and two cases of elbow Charcot arthropathy were included.Three cases showed bone absorption mixed with hyperplasia , one case showed absorption , and one case showed hyperplasia .MRI showed bone absorption , bone hyperplasia , free bone fragment , deformation of the joint , and joint dislocation , and can also show the joint capsule relaxation , uneven hypertrophy and surrounding soft tissue swelling , joint effusion , the tendon and ligament damage by joint instability .In addition, cervical spine MRI can accurately diagnose syringomyelia , which provide good diagnostic basis for Charcot arthropathy .Conclusion MRI could be used as an optimal modality for evaluating Charcot ar-thropathy caused by syringomyelia .%目的:探讨MRI在脊髓空洞症合并夏科氏关节病诊断中的价值,提高对该病的认识。方法回顾性分析经临床确诊的5例脊髓空洞症继发夏科氏关节病的MRI影像表现。结果5例夏科氏关节累及肩关节3例,肘关节2例。其中3例为吸收与增生混合型,1例为吸收型,1例为增生型。 MRI不仅显示受累关节骨端骨质吸收、增生硬化、游离骨块、关节变形及关节脱位,还可以清晰显示关节囊松弛、不均匀肥厚、周围软组织肿胀,关节腔积液,关节不稳造成肌腱、韧带的损伤。此外,颈椎MRI能准确诊断脊髓空洞,为夏科氏关节病提供良好的诊断依据。结论 MRI可以作为诊断脊髓空洞症继发夏科氏关节病的首选检查方法。

  16. Obesity Has Minimal Impact on Short-Term Functional Scores After Reverse Shoulder Arthroplasty for Rotator Cuff Tear Arthropathy.

    Science.gov (United States)

    Morris, Brent J; Haigler, Richard E; Cochran, John M; Laughlin, Mitzi S; Elkousy, Hussein A; Gartsman, Gary M; Edwards, T Bradley

    2016-01-01

    The potential adverse effect of body mass index (BMI) on shoulder function scores after reverse shoulder arthroplasty (RSA) has not been investigated. We conducted a study to examine outcomes of RSA performed for rotator cuff tear arthropathy (RCTA) across BMI categories (normal weight, overweight, obese). We hypothesized that, compared with normal-weight patients, obese patients would have worse shoulder function scores, worse mobility, and more complications. Using a prospective shoulder arthroplasty registry, we identified 77 primary RSAs performed for RCTA with minimum 2-year follow-up. Thirty-four patients had normal weight (BMI 30 kg/m2). Shoulder function scores, mobility, and satisfaction were evaluated before surgery and at final follow-up. The 3 BMI groups were not significantly different on demographic factors, preoperative shoulder function scores, or preoperative mobility (P > .05). For each group, shoulder function scores and mobility significantly improved between the preoperative and final follow-up assessments (P RSA for RCTA in patients regardless of BMI. PMID:27327923

  17. Regional Comparison of the Neurogenic Effects of CNTF-Derived Peptides and Cerebrolysin in AβPP Transgenic Mice

    OpenAIRE

    Rockenstein, Edward; Ubhi, Kiren; Doppler, Edith; Novak, Philipp; Moessler, Herbert; Bin LI; Blanchard, Julie; Grundke-Iqbal, Inge; Iqbal, Khalid; Mante, Michael; Adame, Anthony; Crews, Leslie; Masliah, Eliezer

    2011-01-01

    Adult neurogenesis, the production of new neurons in certain brain regions, is known to decrease with age and the loss of neurogenic potential has been implicated in Alzheimer’s disease (AD), a leading cause of dementia in the elderly. Cerebrolysin (CBL) has been shown to increase neurogenesis in models of stroke and AD. CBL is composed of small peptides with activity similar to neurotrophic factors including ciliary neurotrophic factor (CNTF), which may mediate its neurogenic effects. This s...

  18. Coronavirus-induced demyelination of neural pathways triggers neurogenic bladder overactivity in a mouse model of multiple sclerosis

    OpenAIRE

    McMillan, Matthew T; Pan, Xiao-Qing; Smith, Ariana L.; Newman, Diane K.; Weiss, Susan R.; Ruggieri, Michael R.; Malykhina, Anna P.

    2014-01-01

    In the present study, we aimed to determine whether mice with coronavirus-induced encephalomyelitis (CIE) develop neurogenic bladder dysfunction that is comparable with the neurogenic detrusor overactivity observed in patients with multiple sclerosis. Adult mice (C57BL/6J, 8 wk of age, n = 146) were inoculated with a neurotropic strain of mouse hepatitis virus (A59 strain) and followed for 4 wk. Inoculation with the virus caused a significant neural deficit in mice with an average clinical sy...

  19. A Case of Neuro-Behcet’s Disease Presenting with Central Neurogenic Hyperventilation

    Science.gov (United States)

    Alkhachroum, Ayham M.; Saeed, Saba; Kaur, Jaspreet; Shams, Tanzila; De Georgia, Michael A.

    2016-01-01

    Patient: Female, 46 Final Diagnosis: Central hyperventilation Symptoms: Hyperventilation Medication: — Clinical Procedure: None Specialty: Neurology Objective: Unusual clinical course Background: Behcet’s disease is a chronic inflammatory disorder usually characterized by the triad of oral ulcers, genital ulcers, and uveitis. Central to the pathogenesis of Behcet’s disease is an autoimmune vasculitis. Neurological involvement, so called “Neuro-Behcet’s disease”, occurs in 10–20% of patients, usually from a meningoencephalitis or venous thrombosis. Case Report: We report the case of a 46-year-old patient with Neuro-Behcet’s disease who presented with central neurogenic hyperventilation as a result of brainstem involvement from venulitis. Conclusions: To the best of our knowledge, central neurogenic hyperventilation has not previously been described in a patient with Neuro-Behcet’s disease. PMID:26965646

  20. A simple assessment model to quantifying the dynamic hippocampal neurogenic process in the adult mammalian brain.

    Science.gov (United States)

    Choi, Minee L; Begeti, Faye; Barker, Roger A; Kim, Namho

    2016-04-01

    Adult hippocampal neurogenesis is a highly dynamic process in which new cells are born, but only some of which survive. Of late it has become clear that these surviving newborn neurons have functional roles, most notably in certain forms of memory. Conventional methods to look at adult neurogenesis are based on the quantification of the number of newly born neurons using a simple cell counting methodology. However, this type of approach fails to capture the dynamic aspects of the neurogenic process, where neural proliferation, death and differentiation take place continuously and simultaneously. In this paper, we propose a simple mathematical approach to better understand the adult neurogenic process in the hippocampus which in turn will allow for a better analysis of this process in disease states and following drug therapies. PMID:26443687

  1. Evaluation and Management of Neurogenic Bladder: What Is New in China?

    Science.gov (United States)

    Liao, Limin

    2015-01-01

    Neurogenic bladder (NB) or neurogenic lower urinary tract dysfunction (NLUTD), a dysfunction of the urinary bladder and urethra due to disease of the central nervous system or peripheral nerves, is a major global medical and social problem. Numerous nervous system abnormalities, such as: stroke, Alzheimer's and Parkinson's diseases, traumatic spinal cord injury, spinal cord tumors, congenital spina bifida, and diabetes, can cause NB/NLUTD. There are two major types of bladder control problems associated with NB/NLUTD: the bladder becomes either overactive or underactive depending on the nature, level, and extent of nerve damage. This review specifically focuses on the diagnosis and management of NB/NLUTD in China as well as on recent efforts to treat this disease. PMID:26266405

  2. Endogenous neurogenic cell response in the mature mammalian brain following traumatic injury.

    Science.gov (United States)

    Sun, Dong

    2016-01-01

    In the mature mammalian brain, new neurons are generated throughout life in the neurogenic regions of the subventricular zone (SVZ) and the dentate gyrus (DG) of the hippocampus. Over the past two decades, extensive studies have examined the extent of adult neurogenesis in the SVZ and DG, the role of the adult generated new neurons in normal brain function and the underlying mechanisms regulating the process of adult neurogenesis. The extent and the function of adult neurogenesis under neuropathological conditions have also been explored in varying types of disease models in animals. Increasing evidence has indicated that these endogenous neural stem/progenitor cells may play regenerative and reparative roles in response to CNS injuries or diseases. This review will discuss the potential functions of adult neurogenesis in the injured brain and will describe the recent development of strategies aimed at harnessing this neurogenic capacity in order to repopulate and repair the injured brain following trauma. PMID:25936874

  3. Early revealing of neurogenic disorders of urination in patients with anorectal anomalies

    Directory of Open Access Journals (Sweden)

    Makedonsky I.O.

    2013-03-01

    Full Text Available 148 patients with anorectal malformations (ARM were examined. Using clinical, X-ray, ultrasound and urodynamical methods of detections, factors which can cause bladder dysfunction in anorectal malformations are revealed. It was noted that patients with high and low forms of this defect have significant percentage of neurogenec disorders of urination. Absence of anomalies of spinal column development does not exclude these children from the group of scheduled profound urologic investigation. We propose ultrasound measurement of bladder wall thickness and 4-hour monitoring of voiding, urodynamic examination as early diagnostic methods of neurogenic bladder dysfunctions. For timely revealing and treatment of neurogenic disorders of urination we recommend urologic inves¬tigation to all ARM patients. Improvement of diagnostic methods and development of algorithm of revealing mentioned pathologies against ARM with the aim to prevent com¬plications in the urinary system, being perspective in decreasing lethality and disability.

  4. Viscossuplementação em pacientes com artropatia hemofílica Viscosupplementation in patients with hemophilic arthropathy

    Directory of Open Access Journals (Sweden)

    Flávio Zelada

    2013-02-01

    Full Text Available OBJETIVO: Avaliar se a viscossuplementação com ácido hialurônico em pacientes com artropatia hemofílica grave associada com triancinolona após a lavagem articular com soro fisiológico melhora a dor, a rigidez, a função e a qualidade de vida. MÉTODOS: Onze pacientes com artrite hemofílica de joelhos com e sem acometimento de outras articulações (tornozelos e cotovelos foram submetidos a lavagem articular com soro fisiológico e subsequente infiltração de hilano e triancinolona em todas as articulações acometidas. Responderam os questionários algo-funcionais (WOMAC e Lequesne, escala analógica visual para dor (VAS e SF-36, no pré-operatório, e com um e três meses de pós-operatório. RESULTADOS: A dor (VAS e WOMAC dor e a rigidez (WOMAC rigidez não apresentaram melhora significativa (p=0,3; p=0,2; p=0,1, respectivamente. Porém a função apresentou uma melhora significativa dada pelo WOMAC função e total (11 pontos em média, p=0,04 e p=0,001, respectivamente. A pontuação no questionário de Lequesne não variou significativamente (p=0,1. Porém tantos os componentes mental como físico do SF 36 tiveram melhoras clinicamente relevantes e significativas (p=0,002. CONCLUSÃO: A lavagem articular com soro fisiológico seguida pela infiltração de corticosteroide e hilano é efetiva no tratamento da artropatia hemofílica, sobretudo na melhora funcional e na qualidade de vida. Nível de Evidência IV, Série de casos.OBJECTIVE: To assess whether viscosupplementation with hyaluronic acid in patients with severe hemophilic arthropathy associated with triamcinolone after washing with saline improves joint pain, stiffness, function and quality of life. METHODS: Eleven patients with hemophilic arthritis of the knee with and without involvement of other joints (elbows and ankles underwent joint lavage with saline and subsequent injection of Hylan and triamcinolone in all affected joints. The patients answered the algo

  5. IL28B gene polymorphisms and Th1/Th2 cytokine levels might be associated with HTLV-associated arthropathy.

    Science.gov (United States)

    de Sá, Keyla Santos Guedes; Santana, Bárbara Brasil; de Souza Ferreira, Tuane Carolina; Sousa, Rita Catarina Medeiros; Caldas, Cezar Augusto Muniz; Azevedo, Vânia Nakauth; Feitosa, Rosimar Neris Martins; Machado, Luiz Fernando Almeida; de Oliveira Guimarães Ishak, Marluísa; Ishak, Ricardo; Vallinoto, Antonio Carlos Rosário

    2016-01-01

    The present study is the first investigation of the association between single nucleotide polymorphisms (SNPs - rs8099917, rs12979860 and rs8103142) of the IL28B gene and the development of human T-lymphotropic virus (HTLV)-associated arthropathy (HAA). Individuals with HAA exhibited low interleukin (IL) 6 (p<0.05) and high IL-10 (p<0.05) levels compared with asymptomatic patients. TNF-α/CD4(+) T cell count, TNF-α/CD8(+) T cell count and IFN-γ/proviral load positively correlated in asymptomatic patients. The allelic and genotypic frequencies did not differ between patients with HAA and asymptomatic patients. Seven haplotypes were detected in the investigated population, with haplotype CCT (p<0.05) being the most frequent among the HTLV-infected individuals, while haplotype TTG (p<0.05) was detected in the group with HAA only. Compared with asymptomatic patients, individuals with HAA and genotype TT (rs8099917) exhibited larger numbers of CD8(+) T cells (p<0.05) and higher proviral load levels (p<0.05). Those patients with HAA and genotypes CC (rs12979860) and TT (rs8103142) exhibited high TNF-β (p<0.05) and IFN-γ (p<0.05) levels. Those patients with HAA and genotype CT/TT (rs12979860) exhibited high IL-10 levels (p<0.05). These results suggest that haplotypes CCT and TTG might be associated with susceptibility to HTLV infection and progression to HAA, respectively. Genotype TT (rs8099917) might be a risk factor for elevation of the proviral load and CD8(+) T cell count. In addition, genotypes CC (rs12979860) and TT (rs8103142) seem to be associated with increased TNF-β and IFN-γ levels. PMID:26546777

  6. Urodynamic profile of patients with neurogenic bladder following non-traumatic myelopathies

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    Anupam Gupta

    2013-01-01

    Full Text Available Objective: To observe the urodynamic profile of the patients following non-traumatic myelopathies (NTMs with neurogenic bladder. Setting: Neurological rehabilitation department of university tertiary research hospital. Materials and Methods: Seventy-nine patients (44 men with monophasic NTM, with the age range 8-65 years (31.0 ± 16.0 years, were admitted for inpatients′ rehabilitation. Length of stay in rehabilitation ranged from 6 to 120 days (32.0 ± 24.8 days. Fifty-six patients (70.9% had spinal lesion above D10, 17 had lesion between D10 and L2 (21.5%, and 6 (7.6% had cauda equina syndrome. All patients had neurogenic bladder with urinary complaints. Urodynamic study (UDS was performed in all patients. Results: UDS showed 71.4% patients (40/56 had neurogenic detrusor overactivity (NDO with or without sphincter dyssynergy (DSD with lesion above D10; only 52.9% patients (9/17 had NDO with or without DSD detrusor with lesion between D10 and L2; and majority (5/6 patients had underactive detrusor in the cauda equina group. Bladder management was based on the UDS findings. No significant correlation was found (P > 0.05 between detrusor behavior and the level, severity (ASIA Impairment Scale of spinal injury, or gender using chi-square test. Conclusions: Neurogenic bladder following NTM was observed in all patients. UDS suggested predominantly NDO in lesions above D10 and mixed pattern in between D10 and L2 lesions. No significant correlation was found between detrusor behavior and the level or severity of NTM in the study.

  7. N-Docosahexaenoylethanolamine ameliorates ethanol-induced impairment of neural stem cell neurogenic differentiation.

    Science.gov (United States)

    Rashid, Mohammad Abdur; Kim, Hee-Yong

    2016-03-01

    Previous studies demonstrated that prenatal exposure to ethanol interferes with embryonic and fetal development, and causes abnormal neurodevelopment. Docosahexaenoic acid (DHA), an omega-3 polyunsaturated fatty acid highly enriched in the brain, was shown to be essential for proper brain development and function. Recently, we found that N-docosahexenoyethanolamine (synaptamide), an endogenous metabolite of DHA, is a potent PKA-dependent neurogenic factor for neural stem cell (NSC) differentiation. In this study, we demonstrate that ethanol at pharmacologically relevant concentrations downregulates cAMP signaling in NSC and impairs neurogenic differentiation. In contrast, synaptamide reverses ethanol-impaired NSC neurogenic differentiation through counter-acting on the cAMP production system. NSC exposure to ethanol (25-50 mM) for 4 days dose-dependently decreased the number of Tuj-1 positive neurons and PKA/CREB phosphorylation with a concomitant reduction of cellular cAMP. Ethanol-induced cAMP reduction was accompanied by the inhibition of G-protein activation and expression of adenylyl cyclase (AC) 7 and AC8, as well as PDE4 upregulation. In contrast to ethanol, synaptamide increased cAMP production, GTPγS binding, and expression of AC7 and AC8 isoforms in a cAMP-dependent manner, offsetting the ethanol-induced impairment in neurogenic differentiation. These results indicate that synaptamide can reduce ethanol-induced impairment of neuronal differentiation by counter-affecting shared targets in G-protein coupled receptor (GPCR)/cAMP signaling. The synaptamide-mediated mechanism observed in this study may offer a possible avenue for ameliorating the adverse impact of fetal alcohol exposure on neurodevelopment.

  8. Notch receptor expression in neurogenic regions of the adult zebrafish brain.

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    Vanessa de Oliveira-Carlos

    Full Text Available The adult zebrash brain has a remarkable constitutive neurogenic capacity. The regulation and maintenance of its adult neurogenic niches are poorly understood. In mammals, Notch signaling is involved in stem cell maintenance both in embryonic and adult CNS. To better understand how Notch signaling is involved in stem cell maintenance during adult neurogenesis in zebrafish we analysed Notch receptor expression in five neurogenic zones of the adult zebrafish brain. Combining proliferation and glial markers we identified several subsets of Notch receptor expressing cells. We found that 90 [Formula: see text] of proliferating radial glia express notch1a, notch1b and notch3. In contrast, the proliferating non-glial populations of the dorsal telencephalon and hypothalamus rarely express notch3 and about half express notch1a/1b. In the non-proliferating radial glia notch3 is the predominant receptor throughout the brain. In the ventral telencephalon and in the mitotic area of the optic tectum, where cells have neuroepithelial properties, notch1a/1b/3 are expressed in most proliferating cells. However, in the cerebellar niche, although progenitors also have neuroepithelial properties, only notch1a/1b are expressed in a high number of PCNA [Formula: see text] cells. In this region notch3 expression is mostly in Bergmann glia and at low levels in few PCNA [Formula: see text] cells. Additionally, we found that in the proliferation zone of the ventral telencephalon, Notch receptors display an apical high to basal low gradient of expression. Notch receptors are also expressed in subpopulations of oligodendrocytes, neurons and endothelial cells. We suggest that the partial regional heterogeneity observed for Notch expression in progenitor cells might be related to the cellular diversity present in each of these neurogenic niches.

  9. Hypertonic saline increases vascular permeability in the rat trachea by producing neurogenic inflammation.

    OpenAIRE

    Umeno, E; McDonald, D M; Nadel, J A

    1990-01-01

    In this study, we examined whether inhalation of hypertonic saline aerosols increases vascular permeability in the rat trachea, and we examined the role of neurogenic inflammation in this response. Stereological point counting was performed to measure the percent area occupied by Monastral blue-labeled blood vessels as a means of quantifying the increase in vascular permeability in tracheal whole mounts. Hypertonic saline aerosols (3.6-14.4% NaCl) increased vascular permeability in a dose-dep...

  10. Neurogenic pulmonary edema due to ventriculo-atrial shunt dysfunction: a case report

    OpenAIRE

    Ana Sofia Cruz; Sónia Menezes; Maria Silva

    2016-01-01

    ABSTRACT BACKGROUND AND OBJECTIVES: Pulmonary edema is caused by the accumulation of fluid within the air spaces and the interstitium of the lung. Neurogenic pulmonary edema is a clinical syndrome characterized by the acute onset of pulmonary edema following a significant central nervous system insult. It may be a less-recognized consequence of raised intracranial pressure due to obstructive hydrocephalus by blocked ventricular shunts. It usually appears within minutes to hours after the in...

  11. Neurogenic Inflammation – The Peripheral Nervous System’s Role in Host Defense and Immunopathology

    OpenAIRE

    Chiu, Isaac M.; von Hehn, Christian A.; Woolf, Clifford J.

    2012-01-01

    The peripheral nervous and immune systems are traditionally thought of as serving separate functions. This line is, however, becoming increasingly blurred by new insights into neurogenic inflammation. Nociceptor neurons possess many of the same molecular recognition pathways for danger as immune cells and in response to danger, the peripheral nervous system directly communicates with the immune system, forming an integrated protective mechanism. The dense innervation network of sensory and au...

  12. Heated indoor swimming pools, infants, and the pathogenesis of adolescent idiopathic scoliosis: a neurogenic hypothesis

    OpenAIRE

    McMaster Marianne E

    2011-01-01

    Abstract Background In a case-control study a statistically significant association was recorded between the introduction of infants to heated indoor swimming pools and the development of adolescent idiopathic scoliosis (AIS). In this paper, a neurogenic hypothesis is formulated to explain how toxins produced by chlorine in such pools may act deleteriously on the infant's immature central nervous system, comprising brain and spinal cord, to produce the deformity of AIS. Presentation of the hy...

  13. Changes of neural markers expression during late neurogenic differentiation of human adipose-derived stem cells

    Science.gov (United States)

    Razavi, Shahnaz; Khosravizadeh, Zahra; Bahramian, Hamid; Kazemi, Mohammad

    2015-01-01

    Background: Different studies have been done to obtain sufficient number of neural cells for treatment of neurodegenerative diseases, spinal cord, and traumatic brain injury because neural stem cells are limited in central nerves system. Recently, several studies have shown that adipose-derived stem cells (ADSCs) are the appropriate source of multipotent stem cells. Furthermore, these cells are found in large quantities. The aim of this study was an assessment of proliferation and potential of neurogenic differentiation of ADSCs with passing time. Materials and Methods: Neurosphere formation was used for neural induction in isolated human ADSCs (hADSCs). The rate of proliferation was determined by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay and potential of neural differentiation of induced hADSCs was evaluated by immunocytochemical and real-time reverse transcription polymerase chain reaction analysis after 10 and 14 days post-induction. Results: The rate of proliferation of induced hADSCs increased after 14 days while the expression of nestin, glial fibrillary acidic protein, and microtubule-associated protein 2 was decreased with passing time during neurogenic differentiation. Conclusion: These findings showed that the proliferation of induced cells increased with passing time, but in early neurogenic differentiation of hADSCs, neural expression was higher than late of differentiation. Thus, using of induced cells in early differentiation may be suggested for in vivo application. PMID:26605238

  14. Neurogenic pruritus: an unrecognised problem? A retrospective case series of treatment by acupuncture.

    Science.gov (United States)

    Stellon, Anthony

    2002-12-01

    Intractable localised segmental pruritus without a rash has been reported over the years under various titles depending on the area of the body affected. Notalgia paresthetica and brachioradial pruritus are the two terms used for what is believed to be a form of neuropathy. The clinical observations reported here suggest that other localised cases of pruritus exist that share common clinical features, and the term neurogenic pruritus is suggested to encompass these under one clinical condition. Acupuncture has been used to treat skin conditions, of which pruritus is one symptom. This retrospective study looked at the symptomatic relief of neurogenic pruritus in 16 patients using acupuncture. In 12 cases the affected dermatomes of the body were innervated by cervical spinal nerves, seven innervated by dorsal spinal nerves and four innervated by the lumbar spinal nerves. Seven patients had areas affected by two different regions of the spine. Restricted neck or back movements were noted in patients as were areas of paravertebral spasm or tenderness of the muscles. Total resolution of symptoms as judged by VAS occurred in 75% of patients. Relapse occurred in 37% of patients within 1-12 months following treatment. Acupuncture appeared to be effective in alleviating the distressing symptom of itching in patients presenting with neurogenic pruritus. PMID:12512793

  15. SPOT14-Positive Neural Stem/Progenitor Cells in the Hippocampus Respond Dynamically to Neurogenic Regulators

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    Marlen Knobloch

    2014-11-01

    Full Text Available Proliferation of neural stem/progenitor cells (NSPCs in the adult brain is tightly controlled to prevent exhaustion and to ensure proper neurogenesis. Several extrinsic stimuli affect NSPC regulation. However, the lack of unique markers led to controversial results regarding the in vivo behavior of NSPCs to different stimuli. We recently identified SPOT14, which controls NSPC proliferation through regulation of de novo lipogenesis, selectively in low-proliferating NSPCs. Whether SPOT14-expressing (SPOT14+ NSPCs react in vivo to neurogenic regulators is not known. We show that aging is accompanied by a marked disappearance of SPOT14+ NSPCs, whereas running, a positive neurogenic stimulus, increases proliferation of SPOT14+ NSPCs. Furthermore, transient depletion of highly proliferative cells recruits SPOT14+ NSPCs into the proliferative pool. Additionally, we have established endogenous SPOT14 protein staining, reflecting transgenic SPOT14-GFP expression. Thus, our data identify SPOT14 as a potent marker for adult NSPCs that react dynamically to positive and negative neurogenic regulators.

  16. Complications of untreated and ineffectively treated neurogenic bladder dysfunctions in children: our own practical classification.

    Science.gov (United States)

    Kroll, P; Zachwieja, J

    2016-04-01

    The neurogenic dysfunctions of the detrusor and the sphincter are caused by either a known congenital defect of the nervous system or by acquired damage to the nervous system. In patients with idiopathic bladder dysfunctions neurological examinations fail to reveal any pathology in the nervous system. The treatment strategy for the patient with detrusor-sphincter dysfunction should be based on a comprehensive functional and morphological evaluation. Clean Intermittent Catheterization is mandatory if voiding is ineffective. Reduced bladder capacity related to detrusor overactivity and decreased bladder walls compliance is successfully managed conservatively with oral anticholinergics. Conservative treatment prevents complications in the majority of patients. However, despite proper conservative treatment, some patients still develop complications. We propose our own practical classification of complications characteristic for the bladder and sphincter dysfunctions: 1. Urinary tract infections; 2. Urolithiasis; 3. Anatomic changes in the lower urinary tract; 4. Anatomic changes in the upper urinary tract; 5. Functional disturbances of kidneys parenchyma; 6. Urinary incontinence. Proposed practical classification of complications of bladder and sphincter dysfunctions is clear and simple. This classification can be used both in children with neurogenic and non-neurogenic dysfunctions. It is helpful in planning follow-up procedures and evaluation of treatment results. PMID:27097940

  17. The Efficacy of Magnetic Resonance Imaging and X-Ray in the Evaluation of Response to Radiosynovectomy in Patients with Hemophilic Arthropathy

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    Tamer Özülker

    2011-08-01

    Full Text Available Objective: We aimed to assess the role of Magnetic Resonance Imaging (MRI and X-Ray in the evaluation of response to radiosynovectomy (RS in patients with hemophilic arthropathy. Material and Methods: Eleven patients who suffered from hemophilic arthropathy with a mean age of 11.7 (range between 7-15 were included in this study. 148-185 MBq Yttrium 90 silicate (Y-90 was administered intraarticularly to ten knee joints and one patient was treated with intraarticular 74 MBq Rhenium 186 (Re-186 injection into his ankle. Before radiosynovectomy, plain anteroposterior and lateral X-rays of the target joints were obtained by standard technique. The follow-up MRI and X-ray studies of the patients were done 6 months after RS. Pettersson hemophilic arthropathy scales were utilized to stage the condition of the joints on plain X-ray and classification of the investigated joints on MRI were done according to Denver score. The clinical assessment of the efficacy of the RS was made with the comparison of the average bleedings before and after the intervention. Results: During the 6-month follow-up period after RS, an improvement in number of hemarthrosis 75% or greater compared with the prior six months occurred in six joints (54.5%. The Pettersson scores worsened in 1/11 (9%, remained unchanged in 9/11 (81.8%, and improved in 1/11 (9% joints. At the 6-month follow-up, the MRI score worsened in one (9% and was unchanged in 10/11 joints (90.9%. Conclusion: MRI is a more sensitive tool than plain radiography for evaluating and follow-up of joint disease in persons with hemophilia, but both methods don’t show correlation with the therapeutic response. (MIRT 2011;20:38-44

  18. Botulinumtoxin-A in the treatment for neurogenic bladder dysfunctions in children and adolescents in consideration of Botulinumtoxin-a antibidies in therapie failures

    OpenAIRE

    Herholz, Jacqueline

    2010-01-01

    The standard treatment for neurogenic bladder dysfunctions in children is administration of anticholinergic medication in combination with a intermittend catheteriziation. However, not all patients can be sufficiently stabilized with this established therapy. Botulinum toxins are gaining increasing importance in treating neurogenic and non-neurogenic bladder dysfunctions in children. For my doctoral thesis I studied the efficiency side effects, and causes for failures of this new treatmen...

  19. Examining Reactive Arthropathy in Military Skeletal Assemblages: A Pilot Study Using the Mass Grave Assemblage from the Battle of Towton (1461

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    Meghan Elizabeth Banton

    2014-10-01

    Full Text Available Military personnel are often subjected to physical exertion, sleep deprivation, deficient diets, overcrowding, and stress. All of these influences are capable of compromising the immune system’s ability to ward off disease-causing bacteria, thus explaining why the historical narrative of war is frequently accompanied by reports of death and suffering due to epidemics of infectious diseases. Historically some of the most common infections included: diarrhoea, dysentery, typhoid fever, gonorrhoea, and streptococcal tonsillitis. The bacteria which cause these diseases are also capable of triggering arthritis. When an arthritic condition is triggered by an infectious microbe it can broadly be referred to as “reactive arthropathy,” of which the spondyloarthritides (SpAs are of great interest. Since the bacteria associated with these arthritic conditions are responsible for the epidemics which have plagued combatants for centuries, it is reasonable to assume that reactive arthropathy was present in past military populations. This assertion can be tested through a prevalence study of military related skeletal assemblages. To test the methodology and gain preliminary results for this research project, a pilot study was carried out using remains from the 1461 Battle of Towton. The methodology was deemed to be sound and the statistical results, while not significant, were promising.

  20. O ultra-som na artropatia hemofílica subaguda do joelho Ultrasound in knee sub-acute hemophilic arthropathy

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    Luiz Mario Bellegard

    2006-01-01

    Full Text Available São apresentados 4 casos de Artropatia Hemofílica Subaguda de Joelho em seus aspectos clínicos, radiográficos e ultra-sonográficos. A radiografia tem alterações discretas nas fases iniciais da Artropatia Hemofílica (AH. São enfatizados os aspectos do ultra-som, que proporcionou imagem direta da membrana sinovial no recesso capsular anterior do joelho. Discutimos a possibilidade de utilização da ultra-sonografia como marcador de atividade inflamatória.Here we present 4 cases of Knee Sub-Acute Hemophilic Arthropathy according to clinical, X-ray and ultrasound aspects. The X-ray images show subtle changes in the early phases of Hemophilic Arthropathy (HA. Ultrasound aspects are emphasized, which provided direct image of the synovial membrane at the knee anterior capsular recess. We discuss the potential ultrasound use as a marker of inflammatory activity.

  1. Furosemide modifies heart hypertrophy and glycosaminoglycan myocardium content in a rat model of neurogenic hypertension.

    Science.gov (United States)

    Pourzitaki, Chryssa; Tsaousi, Georgia; Manthou, Maria Eleni; Karakiulakis, Georgios; Kouvelas, Dimitrios; Papakonstantinou, Eleni

    2016-08-01

    Hypertension is a major risk factor for atherogenesis and heart hypertrophy, both of which are associated with specific morphological and functional changes of the myocardium. Glycosaminoglycans (GAGs) are complex molecules involved both in tissue morphology and function. In the present study, we investigated the effects of neurogenic hypertension and subsequent antihypertensive treatment with furosemide, on heart hypertrophy and the content of GAGs in the myocardium. Neurogenic hypertension was achieved in male Wistar rats by bilateral aortic denervation (bAD). At days 2, 7 and 15 after surgery, animals were sacrificed and the hearts were dissected away, weighted, and homogenized. Total GAGs were assessed by measuring the uronic acid content colorimetrically and individual GAGs were isolated and characterized by enzymatic treatment, with GAG-degrading enzymes, using electrophoresis on polyacrylamide gradient gels and cellulose acetate membranes. In bAD-animals blood pressure, blood pressure lability, heart rate and heart weight were significantly increased 15 days postoperatively. These effects were prevented by treatment with furosemide. Major GAGs identified in the heart were chondroitin sulphates, heparin (H), heparan sulphate (HS) and hyaluronic acid. The content of uronic and the relative content of H and HS in the heart in bAD animals significantly decreased from day 2 to day 15 postoperatively. Furosemide prevented the bAD induced decrease in GAG content. Considering that H and HS are potent inhibitors of cardiomyocyte hypertrophy, our results indicate that heart hypertrophy induced by neurogenic hypertension may be associated with decreases in the relative content of heparin and heparan sulphate in the heart. PMID:27221775

  2. Environmental Enrichment, Age, and PPARα Interact to Regulate Proliferation in Neurogenic Niches.

    Science.gov (United States)

    Pérez-Martín, Margarita; Rivera, Patricia; Blanco, Eduardo; Lorefice, Clara; Decara, Juan; Pavón, Francisco J; Serrano, Antonia; Rodríguez de Fonseca, Fernando; Suárez, Juan

    2016-01-01

    Peroxisome proliferator-activated receptor alpha (PPARα) ligands have been shown to modulate recovery after brain insults such as ischemia and irradiation by enhancing neurogenesis. In the present study, we investigated the effect of the genetic deletion of PPARα receptors on the proliferative rate of neural precursor cells (NPC) in the adult brain. The study was performed in aged Pparα(-/-) mice exposed to nutritional (treats) and environmental (games) enrichments for 20 days. We performed immunohistochemical analyses of cells containing the replicating cell DNA marker 5-bromo-2'-deoxyuridine (BrdU+) and the immature neuronal marker doublecortin (Dcx+) in the main neurogenic zones of the adult brain: subgranular zone of dentate gyrus (SGZ), subventricular zone of lateral ventricles (SVZ), and/or hypothalamus. Results indicated a reduction in the number of BrdU+ cells in the neurogenic zones analyzed as well as Dcx+ cells in the SGZ during aging (2, 6, and 18 months). Pparα deficiency alleviated the age-related reduction of NPC proliferation (BrdU+ cells) in the SVZ of the 18-months-old mice. While no genotype effect on NPC proliferation was detected in the SGZ during aging, an accentuated reduction in the number of Dcx+ cells was observed in the SGZ of the 6-months-old Pparα(-/-) mice. Exposing the 18-months-old mice to nutritional and environmental enrichments reversed the Pparα(-/-)-induced impairment of NPC proliferation in the neurogenic zones analyzed. The enriched environment did not modify the number of SGZ Dcx+ cells in the 18 months old Pparα(-/-) mice. These results identify PPARα receptors as a potential target to counteract the naturally observed decline in adult NPC proliferation associated with aging and impoverished environments. PMID:27013951

  3. Environmental Enrichment, Age, and PPARα Interact to Regulate Proliferation in Neurogenic Niches

    Science.gov (United States)

    Pérez-Martín, Margarita; Rivera, Patricia; Blanco, Eduardo; Lorefice, Clara; Decara, Juan; Pavón, Francisco J.; Serrano, Antonia; Rodríguez de Fonseca, Fernando; Suárez, Juan

    2016-01-01

    Peroxisome proliferator-activated receptor alpha (PPARα) ligands have been shown to modulate recovery after brain insults such as ischemia and irradiation by enhancing neurogenesis. In the present study, we investigated the effect of the genetic deletion of PPARα receptors on the proliferative rate of neural precursor cells (NPC) in the adult brain. The study was performed in aged Pparα−/− mice exposed to nutritional (treats) and environmental (games) enrichments for 20 days. We performed immunohistochemical analyses of cells containing the replicating cell DNA marker 5-bromo-2′-deoxyuridine (BrdU+) and the immature neuronal marker doublecortin (Dcx+) in the main neurogenic zones of the adult brain: subgranular zone of dentate gyrus (SGZ), subventricular zone of lateral ventricles (SVZ), and/or hypothalamus. Results indicated a reduction in the number of BrdU+ cells in the neurogenic zones analyzed as well as Dcx+ cells in the SGZ during aging (2, 6, and 18 months). Pparα deficiency alleviated the age-related reduction of NPC proliferation (BrdU+ cells) in the SVZ of the 18-months-old mice. While no genotype effect on NPC proliferation was detected in the SGZ during aging, an accentuated reduction in the number of Dcx+ cells was observed in the SGZ of the 6-months-old Pparα−/− mice. Exposing the 18-months-old mice to nutritional and environmental enrichments reversed the Pparα−/−-induced impairment of NPC proliferation in the neurogenic zones analyzed. The enriched environment did not modify the number of SGZ Dcx+ cells in the 18 months old Pparα−/− mice. These results identify PPARα receptors as a potential target to counteract the naturally observed decline in adult NPC proliferation associated with aging and impoverished environments. PMID:27013951

  4. Bioimpedance based monitoring system for people with neurogenic dysfunction of the urinary bladder.

    Science.gov (United States)

    Palla, Alessandro; Rossi, Stefano; Fanucci, Luca

    2015-01-01

    Patients with impaired bladder volume sensation have the necessity to monitor bladder level in order to avoid urinary tract infections and urinary reflux that can lead to renal failure. In this paper the the effectiveness of an embedded and wearable solution for bladder volume monitoring using the bioimpedance measurement is tested. Data are streamed real-time using Bluetooth wireless technology. The bioimpedance measurements on a healthy subject prove the effectiveness of the proposed solution. In the future the system will be evaluated in real world scenarios with patients affected by spinal paralysis and bladder neurogenic dysfunction. PMID:26294580

  5. Neurogenic benign fasciculations, pseudomyotonia, and pseudotetany. A disease in search of a name.

    Science.gov (United States)

    Coërs, C; Telerman-Toppet, N; Durdu, J

    1981-05-01

    We studied two patients with abnormal spontaneous muscular activity. The first had widespread fasciculations, painful spasms, delayed muscular relaxation, and hyperhidrosis. Improvement occurred after several years. The second case had generalized paresthesia, mild stiffness, a positive result from Trusseau's test, and was relieved by administration of carbamazepine. Both patients had abnormal conduction velocity. Examination of muscle biopsy specimens disclosed fiber type grouping and increased collateral ramification of motor axons. These observations exemplify symptoms and signs that resemble those of myotonia and tetany and occasionally occur in partial denervation. they provide additional evidence of the neurogenic nature of Isaacs-Mertens syndrome. PMID:7224912

  6. Edema pulmonar neurogênico: relato de dois casos Neurogenic pulmonary edema: report of two cases

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    Desanka Dragosavac

    1997-06-01

    Full Text Available O edema pulmonar neurogênico é rara e grave complicação de pacientes com traumatismo craniencefálico (TCE. Pode ocorrer também em outras patologias do sistema nervoso central, tais como acidentes vasculares cerebrais (AVC, tumores ou após crises epilépticas, entre outras. Foram avaliados 36 casos com TCE grave e quatro pacientes com AVC, internados na UTI geral, no período de janeiro a setembro 1995. Nesse intervalo de tempo foram diagnosticados dois casos de edema pulmonar neurogênico, um ocorrendo em paciente com TCE grave e outro em paciente com AVC hemorrágico. O diagnóstico foi estabelecido pelo rápido desenvolvimento de edema pulmonar, com hipoxemia grave, queda da complacência pulmonar e infiltrados difusos bilaterais sem história prévia de aspiração traqueal ou outro fator de risco para o desenvolvimento de síndrome de angústia respiratória aguda. No primeiro paciente com trauma craniencefálico, o edema neurogênico foi diagnosticado na internação, uma hora após o trauma, com concomitante reação inflamatória grave e boa evolução em três dias. O outro caso, com AVC hemorrágico, desenvolveu edema neurogênico no quarto dia após drenagem de hematoma intraparenquimatoso, evoluindo para o óbito.Neurogenic pulmonary edema is a rare and serious complication in patients with head injury. It also may develop after a variety of cerebral insults such as subarachnoid hemorrhage, brain tumors and after epileptic seizures. Thirty six patients with severe head injury and four patients with cerebrovascular insults treated in Intensive Care Unit of HC-UNICAMP from January to September 1995 were evaluated. In this period there were two patients with neurogenic pulmonary edema, one with head injury and other with intracerebral hemorrhage. Diagnosis was made by rapid onset of pulmonary edema, severe hypoxemia, decrease of pulmonary complacence and diffuse pulmonary infiltrations, without previous history of tracheal

  7. Transient Receptor Potential Ankyrin 1 (TRPA1) Channel and Neurogenic Inflammation in Pathogenesis of Asthma

    Science.gov (United States)

    Yang, Hang; Li, ShuZhuang

    2016-01-01

    Asthma is characterized by airway inflammation, airway obstruction, and airway hyperresponsiveness (AHR), and it affects 300 million people worldwide. However, our current understanding of the molecular mechanisms that underlie asthma remains limited. Recent studies have suggested that transient receptor potential ankyrin 1 (TRPA1), one of the transient receptor potential cation channels, may be involved in airway inflammation in asthma. The present review discusses the relationship between TRPA1 and neurogenic inflammation in asthma, hoping to enhance our understanding of the mechanisms of airway inflammation in asthma. PMID:27539812

  8. Cerebral cortical neurons with activity linked to central neurogenic spontaneous and evoked elevations in cerebral blood flow

    Science.gov (United States)

    Golanov, E. V.; Reis, D. J.

    1996-01-01

    We recorded neurons in rat cerebral cortex with activity relating to the neurogenic elevations in regional cerebral blood flow (rCBF) coupled to stereotyped bursts of EEG activity, burst-cerebrovascular wave complexes, appearing spontaneously or evoked by electrical stimulation of rostral ventrolateral medulla (RVL) or fastigial nucleus (FN). Of 333 spontaneously active neurons only 15 (5%), in layers 5-6, consistently (P neurons in deep cortical laminae whose activity correlates with neurogenic elevations of rCBF. These neurons may function to transduce afferent neuronal signals into vasodilation.

  9. Cocaine and MDMA Induce Cellular and Molecular Changes in Adult Neurogenic Systems: Functional Implications

    Directory of Open Access Journals (Sweden)

    Vivian Capilla-Gonzalez

    2011-06-01

    Full Text Available The capacity of the brain to generate new adult neurons is a recent discovery that challenges the old theory of an immutable adult brain. A new and fascinating field of research now focuses on this regenerative process. The two brain systems that constantly produce new adult neurons, known as the adult neurogenic systems, are the dentate gyrus (DG of the hippocampus and the lateral ventricules/olfactory bulb system. Both systems are involved in memory and learning processes. Different drugs of abuse, such as cocaine and MDMA, have been shown to produce cellular and molecular changes that affect adult neurogenesis. This review summarizes the effects that these drugs have on the adult neurogenic systems. The functional relevance of adult neurogenesis is obscured by the functions of the systems that integrate adult neurons. Therefore, we explore the effects that cocaine and MDMA produce not only on adult neurogenesis, but also on the DG and olfactory bulbs. Finally, we discuss the possible role of new adult neurons in cocaine- and MDMA-induced impairments. We conclude that, although harmful drug effects are produced at multiple physiological and anatomical levels, the specific consequences of reduced hippocampus neurogenesis are unclear and require further exploration.

  10. Effects of sangre de drago in an in vitro model of cutaneous neurogenic inflammation.

    Science.gov (United States)

    Pereira, Ulysse; Garcia-Le Gal, Caridad; Le Gal, Grégoire; Boulais, Nicholas; Lebonvallet, Nicolas; Dorange, Germaine; Lefeuvre, Luc; Gougerot, Agnés; Misery, Laurent

    2010-09-01

    Sangre de drago (SD) is a viscous bright red resin collected from Croton lechleri trees that grow in the South American jungle. This sap is used extensively in the native pharmacopoeia to treat skin disorders. Its effectiveness as an inhibitor of neurogenic inflammation has been recently demonstrated. To understand the underlying mechanisms of these effects, we examined the ability of SD to reduce substance P (SP) release in an in vitro model of cutaneous neurogenic inflammation (CNI). This model is based on an enzyme immunoassay of SP (an inducer of CNI) in a porcine co-culture of dorsal root ganglion neurons and keratinocytes. After incubation with different concentrations of SD, we noted an immediate and significant dose-dependent decrease in basal SP release, with average values of 32% at 1% SD (v/v) and 26% at 0.1% (v/v). On the other hand, pretreatment (72 or 1 h) of the co-culture with 1% SD (v/v) was sufficient to induce a 111% (72 h) or 65% (1 h) inhibition of capsaicin-induced SP release, while 0.1% SD (v/v) triggered a 109% (72 h) or 30% (1 h) inhibition. We conclude that sangre de drago is a potent inhibitor of CNI through direct inhibition of neuropeptide release by sensory afferent nerves.

  11. Electrically evoked neuropeptide release and neurogenic inflammation differ between rat and human skin.

    Science.gov (United States)

    Sauerstein, K; Klede, M; Hilliges, M; Schmelz, M

    2000-12-15

    Protein extravasation and vasodilatation can be induced by neuropeptides released from nociceptive afferents (neurogenic inflammation). We measured electrically evoked neuropeptide release and concomitant protein extravasation in human and rat skin using intradermal microdialysis. Plasmapheresis capillaries were inserted intradermally at a length of 1.5 cm in the volar forearm of human subjects or abdominal skin of rats. Capillaries were perfused with Ringer solution at a flow rate of 2.5 or 1.6 microl min(-1). After a baseline period of 60 min capillaries were stimulated electrically (1 Hz, 80 mA, 0.5 ms or 4 Hz, 30 mA, 0.5 ms) for 30 min using a surface electrode directly above the capillaries and a stainless-steel wire inserted in the capillaries. Total protein concentration was assessed photometrically and calcitonin gene-related peptide (CGRP) and substance P (SP) concentrations were measured by enzyme-linked immunosorbent assay (ELISA). In rat skin, electrical stimulation increased CGRP and total protein concentration in the dialysate. SP measurements showed a larger variance but only for the 1 Hz stimulation was the increased release significant. In human skin, electrical stimulation provoked a large flare reaction and at a frequency of 4 Hz both CGRP and SP concentrations increased significantly. In spite of the large flare reactions no protein extravasation was induced, which suggests major species differences. It will be of interest to investigate whether the lack of neurogenic protein extravasation is also valid under pathophysiological conditions. PMID:11118507

  12. Are neural crest stem cells the missing link between hematopoietic and neurogenic niches?

    Science.gov (United States)

    Coste, Cécile; Neirinckx, Virginie; Gothot, André; Wislet, Sabine; Rogister, Bernard

    2015-01-01

    Hematopoietic niches are defined as cellular and molecular microenvironments that regulate hematopoietic stem cell (HSC) function together with stem cell autonomous mechanisms. Many different cell types have been characterized as contributors to the formation of HSC niches, such as osteoblasts, endothelial cells, Schwann cells, and mesenchymal progenitors. These mesenchymal progenitors have themselves been classified as CXC chemokine ligand (CXCL) 12-abundant reticular (CAR) cells, stem cell factor expressing cells, or nestin-positive mesenchymal stem cells (MSCs), which have been recently identified as neural crest-derived cells (NCSCs). Together, these cells are spatially associated with HSCs and believed to provide appropriate microenvironments for HSC self-renewal, differentiation, mobilization and hibernation both by cell-cell contact and soluble factors. Interestingly, it appears that regulatory pathways governing the hematopoietic niche homeostasis are operating in the neurogenic niche as well. Therefore, this review paper aims to compare both the regulation of hematopoietic and neurogenic niches, in order to highlight the role of NCSCs and nervous system components in the development and the regulation of the hematopoietic system.

  13. Are neural crest stem cells the missing link between hematopoietic and neurogenic niches?

    Directory of Open Access Journals (Sweden)

    Cécile eCoste

    2015-06-01

    Full Text Available Hematopoietic niches are defined as cellular and molecular microenvironments that regulate hematopoietic stem cell (HSC function together with stem cell autonomous mechanisms. Many different cell types have been characterized as contributors to the formation of HSC niches, such as osteoblasts, endothelial cells, Schwann cells, and mesenchymal progenitors. These mesenchymal progenitors have themselves been classified as CXC chemokine ligand (CXCL12-abundant reticular (CAR cells, stem cell factor expressing cells, or nestin-positive mesenchymal stem cells (MSCs, which have been recently identified as neural crest-derived cells (NCSCs. Together, these cells are spatially associated with HSCs and believed to provide appropriate microenvironments for HSC self-renewal, differentiation, mobilization and hibernation both by cell-to-cell contact and soluble factors. Interestingly, it appears that regulatory pathways governing the hematopoietic niche homeostasis are operating in the neurogenic niche as well. Therefore, this review paper aims to compare both the regulation of hematopoietic and neurogenic niches, in order to highlight the role of NCSCs and nervous system components in the development and the regulation of the hematopoietic system.

  14. Malignant neurogenic neoplasms of the head and neck; Zlosliwe nowotwory neurogenne glowy i szyi

    Energy Technology Data Exchange (ETDEWEB)

    Kuczkowski, J.; Starzynska, A. [Akademia Medyczna, Gdansk (Poland)

    1996-12-31

    The authors present 17 cases of malignant neurogenic neoplasms of the head and neck observed in the Department of Otolaryngology in the years 1948-1993. The latest opinions on etiopathology, diagnosis and treatment of these tumors were described. Age and sex of patients, localization of tumor, symptoms histopathology and treatment were analyzed. Progressions of the disease were estimated retrospectively. It has been proved that these tumors develop quickly, give pain and paresthesia. Their diagnosis is very difficult because of their submucosal growth and difficult histopathological interpretation. A characteristic feature of these neurogenic tumors is the ability to give distant metastases. This feature differentiates them from squamous neoplasms, which give mainly nodal metastases. All the patients were subjected to surgery combined with conventional or high voltage radiotherapy. The positive effect of combined chemotherapy in cases of esthesioneuroblastoma is worthy of note. The prognosis in these tumors is often unfavorable. In the group under discussion 13 patients died because of recurrences, two patients are considered to be cured and the remaining 2 patients have had no recurrence for 2 and 3 years. (author) 15 refs, 2 figs, 2 tabs

  15. Non-Traditional Management of the Neurogenic Bladder: Tissue Engineering and Neuromodulation

    Directory of Open Access Journals (Sweden)

    Jane M. Lewis

    2007-01-01

    Full Text Available Patients with spina bifida and a neurogenic bladder have traditionally been managed with clean intermittent catheterization and pharmacotherapy in order to treat abnormal bladder wall dynamics, protect the upper urinary tract from damage, and achieve urinary continence. However, some patients will fail this therapy and require surgical reconstruction in the form of bladder augmentation surgery using reconfigured intestine or stomach to increase the bladder capacity while reducing the internal storage pressure. Despite functional success of bladder augmentation in achieving a low pressure reservoir, there are several associated complications of this operation and patients do not have the ability to volitionally void. For these reasons, alternative treatments have been sought. Two exciting alternative approaches that are currently being investigated are tissue engineering and neuromodulation. Tissue engineering aims to create new bladder tissue for replacement purposes with both “seeded” and “unseeded” technology. Advances in the fields of nanotechnology and stem cell biology have further enhanced these tissue engineering technologies. Neuromodulation therapies directly address the root of the problem in patients with spina bifida and a neurogenic bladder, namely the abnormal relationship between the nerves and the bladder wall. These therapies include transurethral bladder electrostimulation, sacral neuromodulation, and neurosurgical techniques such as selective sacral rhizotomy and artificial somatic-autonomic reflex pathway construction. This review will discuss both tissue engineering techniques and neuromodulation therapies in more detail including rationale, experimental data, current status of clinical application, and future direction.

  16. p73 is required for ependymal cell maturation and neurogenic SVZ cytoarchitecture.

    Science.gov (United States)

    Gonzalez-Cano, L; Fuertes-Alvarez, S; Robledinos-Anton, N; Bizy, A; Villena-Cortes, A; Fariñas, I; Marques, M M; Marin, Maria C

    2016-07-01

    The adult subventricular zone (SVZ) is a highly organized microenvironment established during the first postnatal days when radial glia cells begin to transform into type B-cells and ependymal cells, all of which will form regenerative units, pinwheels, along the lateral wall of the lateral ventricle. Here, we identify p73, a p53 homologue, as a critical factor controlling both cell-type specification and structural organization of the developing mouse SVZ. We describe that p73 deficiency halts the transition of the radial glia into ependymal cells, leading to the emergence of immature cells with abnormal identities in the ventricle and resulting in loss of the ventricular integrity. p73-deficient ependymal cells have noticeably impaired ciliogenesis and they fail to organize into pinwheels, disrupting SVZ niche structure and function. Therefore, p73 is essential for appropriate ependymal cell maturation and the establishment of the neurogenic niche architecture. Accordingly, lack of p73 results in impaired neurogenesis. Moreover, p73 is required for translational planar cell polarity establishment, since p73 deficiency results in profound defects in cilia organization in individual cells and in intercellular patch orientation. Thus, our data reveal a completely new function of p73, independent of p53, in the neurogenic architecture of the SVZ of rodent brain and in the establishment of ependymal planar cell polarity with important implications in neurogenesis. © 2015 Wiley Periodicals, Inc. Develop Neurobiol 76: 730-747, 2016. PMID:26482843

  17. Differential vascular permeability along the forebrain ventricular neurogenic niche in the adult murine brain.

    Science.gov (United States)

    Colín-Castelán, Dannia; Ramírez-Santos, Jesús; Gutiérrez-Ospina, Gabriel

    2016-02-01

    Adult neurogenesis is influenced by blood-borne factors. In this context, greater or lesser vascular permeability along neurogenic niches would expose differentially neural stem cells (NSCs), transit amplifying cells (TACs), and neuroblasts to such factors. Here we evaluate endothelial cell morphology and vascular permeability along the forebrain neurogenic niche in the adult brain. Our results confirm that the subventricular zone (SVZ) contains highly permeable, discontinuous blood vessels, some of which allow the extravasation of molecules larger than those previously reported. In contrast, the rostral migratory stream (RMS) and the olfactory bulb core (OBc) display mostly impermeable, continuous blood vessels. These results imply that NSCs, TACs, and neuroblasts located within the SVZ are exposed more readily to blood-borne molecules, including those with very high molecular weights, than those positioned along the RMS and the OBc, subregions in which every stage of neurogenesis also takes place. These observations suggest that the existence of specialized vascular niches is not a precondition for neurogenesis to occur; specialized vascular beds might be essential for keeping high rates of proliferation and/or differential differentiation of neural precursors located at distinct domains. PMID:26492830

  18. Effects and Safety of Aqueous Extract of Poncirus fructus in Spinal Cord Injury with Neurogenic Bowel

    Directory of Open Access Journals (Sweden)

    Ji Hee Kim

    2016-01-01

    Full Text Available Objective. To investigate the effects and safety of the aqueous extract of the dried, immature fruit of Poncirus trifoliata (L. Raf., known as Poncirus fructus (PF, in spinal cord injury (SCI patients with neurogenic bowel. Methods. Thirty-one SCI patients with neurogenic bowel were recruited. Patients were evaluated based on clinical information, constipation score, Bristol Stool Form Scale, stool retention score using plain abdominal radiograph, and colon transit time. PF was administered in dosages of 800 mg each prior to breakfast and lunch for 14 days. Results. The morphological feature of the stool before and after administration indicated a statistically significant difference from 3.52 ± 1.33 to 4.32 ± 1.44 points (p<0.05. Stool retention score before and after administration of PF was represented with low significance (7.25 ± 1.60 to 6.46 ± 1.53 points in the whole colon (p<0.05, and the colon transit time was significantly shortened (57.41 ± 20.7 to 41.2 ± 25.5 hours in terms of the whole transit time (p<0.05. Side effects were observed in 7 people (28.0% consisting of 2 people with soft stools and 5 people with diarrhea. Conclusion. For SCI patients, PF administration significantly improved defecation patterns, defecation retention, and colon transit time. PF could be an effective aid to improve colonic motility and constipation.

  19. Recent Advances in Neurogenic Small Molecules as Innovative Treatments for Neurodegenerative Diseases.

    Science.gov (United States)

    Herrera-Arozamena, Clara; Martí-Marí, Olaia; Estrada, Martín; de la Fuente Revenga, Mario; Rodríguez-Franco, María Isabel

    2016-01-01

    The central nervous system of adult mammals has long been considered as a complex static structure unable to undergo any regenerative process to refurbish its dead nodes. This dogma was challenged by Altman in the 1960s and neuron self-renewal has been demonstrated ever since in many species, including humans. Aging, neurodegenerative, and some mental diseases are associated with an exponential decrease in brain neurogenesis. Therefore, the controlled pharmacological stimulation of the endogenous neural stem cells (NSCs) niches might counteract the neuronal loss in Alzheimer's disease (AD) and other pathologies, opening an exciting new therapeutic avenue. In the last years, druggable molecular targets and signalling pathways involved in neurogenic processes have been identified, and as a consequence, different drug types have been developed and tested in neuronal plasticity. This review focuses on recent advances in neurogenic agents acting at serotonin and/or melatonin systems, Wnt/β-catenin pathway, sigma receptors, nicotinamide phosphoribosyltransferase (NAMPT) and nuclear erythroid 2-related factor (Nrf2). PMID:27598108

  20. Type I autoimmune hepatitis, inverted psoriasis with psoriatic arthropathy and type 2 diabetes mellitus as complications of a chronic B virus hepatitis treated with interferon - Case report

    Directory of Open Access Journals (Sweden)

    George Săraci

    2012-06-01

    Full Text Available We present the case of a 31 year old male patient, admitted in the 3rd Medical Clinic Cluj-Napoca for asthenia, fatigue, effort hepatalgia,pain located in the legs and small joints of the hands. Patient has been diagnosed a year ago with chronic B viral hepatitis and receivedPeginterferon alpha 2a treatment. After performing clinical and paraclinical exams we established that patient suffers from type I autoimmunehepatitis, inverted psoriasis with psoriatic arthropathy, recent onset of type II diabetes mellitus. These conditions are likely to appear consecutivelyto Interferon therapy. The markers for B virus hepatitis (Ag-HBs, IgM-HBc, AgHBe, ADN-HBV were negative. The evolution was favorableafter therapy with immunosuppressants, corticoids, oral antidiabetics and antisecretors.

  1. Neurogenic Stuttering

    Science.gov (United States)

    ... show awareness, and possibly express anxiety and even depression about the difficulty they encounter in speaking. This may be accompanied by other behaviors, which may include: Secondary or associated behaviors, such as obvious tension and struggle in speech production; movements of ...

  2. Effectiveness of interspinous implant surgery in patients with intermittent neurogenic claudication: a systematic review and meta-analysis

    NARCIS (Netherlands)

    Moojen, W.A.; Arts, M.P.; Bartels, R.H.M.A.; Jacobs, W.C.; Peul, W.C.

    2011-01-01

    INTRODUCTION: Despite an increasing implantation rate of interspinous process distraction (IPD) devices in the treatment of intermittent neurogenic claudication (INC), definitive evidence on the clinical effectiveness of implants is lacking. The main objective of this review was to perform a meta-an

  3. Effectiveness of interspinous implant surgery in patients with intermittent neurogenic claudication : a systematic review and meta-analysis

    NARCIS (Netherlands)

    Moojen, Wouter A.; Arts, Mark P.; Bartels, Ronald H. M. A.; Jacobs, Wilco C. H.; Peul, Wilco C.

    2011-01-01

    Despite an increasing implantation rate of interspinous process distraction (IPD) devices in the treatment of intermittent neurogenic claudication (INC), definitive evidence on the clinical effectiveness of implants is lacking. The main objective of this review was to perform a meta-analysis of all

  4. Paravertebral Neurogenic Tumors with Intraspinal Extension: Preoperative Evaluation and Surgical Approach

    International Nuclear Information System (INIS)

    Aim of Work: To achieve adequate excision of paravertebral neurogenic tumors with intra spinal extension, safe decompression of spinal cord and preservation of spine stability. Patients and Methods: From Nov. 2000 till July 2009 sixteen patients of paravertebral neurogenic tumors with intraspinal extension (dumbbell tumors) were operated upon by combined team work of surgical oncology and neurosurgery at the National Cancer Institute and at Kasr-Al Einy Hospitals, Cairo University. All patients had C-T with guided biopsy and MRI to evaluate extent of tumor bone invasion, intraspinal component, to decide surgical approach and the need for spine fixation. Patients were referred postoperatively to I.C.U for stabilization of general condition. Follow-up with radiology was done for a period from 3-36 month. Results: The group of patients were 9 males and 7 females with age range 1.5-47 year, 8 patients had tumors in post. Mediastinum, 7 in the retroperitoneal space and one in the cervicothoracic inlet. Benign schwannoma were diagnosed in 5 cases, malignant schwannoma in 3, neu-ro fibromatosis in one case, neuroblastoma in 3 cases, ganglioneuroblastoma in 2 cases and ganglioneuroma in 2 cases. Anterior transthoracic resection through posterolateral thoracotomy was used in 6 cases, anterior transabdominal resection was done in 6 cases through midline or transverse incisions. Combined anterior and posterior approach was used in 3 cases while Posterior approach was done in one case using medial para scapular incision. Delivery of the tumor was done in 8 cases, widening of the intervertebral foramina in 3 cases, costotransversectomy with lateral laminectomy in 3 cases while posterior laminectomy and total vertebrectomy was done in one case. We fixed the spine in 3 cases using Z-plate and screws, lateral plates and screws with either iliac crest or isobone graft. All cord compression manifestations improved postoperatively with perfect spine stability. Morbidity was detected

  5. Development of the adult neurogenic niche in the hippocampus of mice

    Directory of Open Access Journals (Sweden)

    Zeina eNicola

    2015-05-01

    Full Text Available When does adult hippocampal neurogenesis begin? We describe the development of the neurogenic niche in the subgranular zone (SGZ of the hippocampal dentate gyrus. We did so from the perspective of the situation in the adult.Ontogeny of the dentate gyrus is complex and results in an ectopic neurogenic niche that lifelong generates new granule cells. Neurogenesis during the fetal and early postnatal periods builds the dentate gyrus and gives way to activity-dependent adult neurogenesis. We used markers most relevant to adult neurogenesis research to describe this transition: Nestin, Sox2, BLBP, GFAP, Tbr2, Doublecortin (DCX, NeuroD1 and Prox1. We found that massive changes and a local condensation of proliferating precursor cells occurs between postnatal day 7 (P7, near the peak in proliferation, and P14. Before and around P7, the spatial distribution of cells and the co-localization of markers were distinct from the situation in the adult. Unlike the adult SGZ, the marker pair Nestin/Sox2 and the radial glial marker BLBP were not overlapping during embryonic development, presumably indicating different types of radial glia-like cells. Before P7 GFAP-positive cells in the hilus lacked the radial orientation that is characteristic of the adult type-1 cells. DCX, which is concentrated in type-2b and type-3 progenitor cells and early postmitotic neurons in the adult, showed diffuse expression before P7. Intermediate progenitor cell marker Tbr2 became restricted to the SGZ but was found in the granule cell layer and hilus before. Lineage markers NeuroD1 and Prox1 confirmed this pattern.We conclude that the neurogenic niche of adult neurogenesis is in place well before true adulthood. This might indicate that consistent with the hypothesized function of adult neurogenesis in activity-dependent plasticity, the early transition from postnatal neurogenesis to adult neurogenesis coincides with the time, when the young mice start to become active themselves.

  6. Transient receptor potential ankyrin 1 channel localized to non-neuronal airway cells promotes non-neurogenic inflammation.

    Directory of Open Access Journals (Sweden)

    Romina Nassini

    Full Text Available BACKGROUND: The transient receptor potential ankyrin 1 (TRPA1 channel, localized to airway sensory nerves, has been proposed to mediate airway inflammation evoked by allergen and cigarette smoke (CS in rodents, via a neurogenic mechanism. However the limited clinical evidence for the role of neurogenic inflammation in asthma or chronic obstructive pulmonary disease raises an alternative possibility that airway inflammation is promoted by non-neuronal TRPA1. METHODOLOGY/PRINCIPAL FINDINGS: By using Real-Time PCR and calcium imaging, we found that cultured human airway cells, including fibroblasts, epithelial and smooth muscle cells express functional TRPA1 channels. By using immunohistochemistry, TRPA1 staining was observed in airway epithelial and smooth muscle cells in sections taken from human airways and lung, and from airways and lung of wild-type, but not TRPA1-deficient mice. In cultured human airway epithelial and smooth muscle cells and fibroblasts, acrolein and CS extract evoked IL-8 release, a response selectively reduced by TRPA1 antagonists. Capsaicin, agonist of the transient receptor potential vanilloid 1 (TRPV1, a channel co-expressed with TRPA1 by airway sensory nerves, and acrolein or CS (TRPA1 agonists, or the neuropeptide substance P (SP, which is released from sensory nerve terminals by capsaicin, acrolein or CS, produced neurogenic inflammation in mouse airways. However, only acrolein and CS, but not capsaicin or SP, released the keratinocyte chemoattractant (CXCL-1/KC, IL-8 analogue in bronchoalveolar lavage (BAL fluid of wild-type mice. This effect of TRPA1 agonists was attenuated by TRPA1 antagonism or in TRPA1-deficient mice, but not by pharmacological ablation of sensory nerves. CONCLUSIONS: Our results demonstrate that, although either TRPV1 or TRPA1 activation causes airway neurogenic inflammation, solely TRPA1 activation orchestrates an additional inflammatory response which is not neurogenic. This finding suggests

  7. [Role of thermo TRP channels in cutaneous neurogenic inflammation and itch].

    Science.gov (United States)

    XIE, Zhi-qiang

    2009-07-01

    The temperature-sensitive transient receptor potential (TRP) channels, is also called thermo TRP, including TRPV1, TRPV2, TRPV3, TRPV4, TRPM8 and TRPA1, which are expressed in sensory neurons and non-neuronal cells (e.g.keratinocyte, mast cell) of the skin. Thermo TRP channels are activated/sensitized by physical and chemical mediators, which participate in thermosensation and thermoregulation, so that they are key players in pruritus or pain pathogenesis. Thermo TRP channels are also involved in cutaneous neurogenic inflammation, thus they are regarded as molecular targets for future therapy in skin inflammation, pruritus and pain. In addition, following a basic syntax and molecular substrate of nociception and pruriception established by TRP channels-centered concept, the sensory categories can be distinguished and re-defined. Thermo TRP channels should be taken into account when analyzing the pathogenesis and management of itch or pruritic dermatosis.

  8. Transpulmonary Thermodilution-Based Management of Neurogenic Pulmonary Edema After Subarachnoid Hemorrhage.

    Science.gov (United States)

    Mutoh, Tatsushi; Kazumata, Ken; Ueyama-Mutoh, Tomoko; Taki, Yasuyuki; Ishikawa, Tatsuya

    2015-11-01

    Neurogenic pulmonary edema (NPE) is a potentially catastrophic but treatable systemic event after subarachnoid hemorrhage (SAH). The development of NPE most frequently occurs immediately after SAH, and the severity is usually self-limiting. Despite extensive research efforts and a breadth of collective clinical experience, accurate diagnosis of NPE can be difficult, and effective hemodynamic treatment options are limited. Recently, a bedside transpulmonary thermodilution device has been introduced that traces physiological patterns consistent with current theories regarding the mechanism (hydrostatic or permeability PE) of NPE. This article provides an overview of the clinical usefulness of the advanced technique for use in the neurointensive care unit for the diagnosis and management of post-SAH NPE.

  9. [Neurogenic bladder function disorders in patients with meningomyelocele: S2k guidelines on diagnostics and therapy].

    Science.gov (United States)

    Stein, R; Assion, C; Beetz, R; Bürst, M; Cremer, R; Ermert, A; Goepel, M; Kuwertz-Bröking, E; Ludwikowski, B; Michael, T; Pannek, J; Peters, H; Rohrmann, D; Rübben, I; Schröder, A; Trollmann, R; Thüroff, J W; Wagner, W

    2015-02-01

    The treatment of children and adolescents with meningomyelocele has experienced a clear change in the last 30 years. The establishment of pharmacotherapy, clean intermittent catheterization (CIC) and infection prophylaxis have improved the prognosis for patients and have led to new therapeutic strategies. The interdisciplinary cooperation between neonatologists, neurosurgeons, pediatric neurologists, pediatric urologists, pediatric nephrologists, pediatric orthopedists and pediatric surgeons leads to optimization of individualized therapy. These guidelines present definitions and classifications, investigations and timing which are described in detail. The conservative and operative therapy options for neurogenic bladder function disorders are described and discussed with reference to the current literature. The brief overview provides in each case assistance for the treating physician in the care of this patient group and facilitates the interdisciplinary cooperation. PMID:25690576

  10. 神经源性肺水肿%Neurogenic pulmonary edema

    Institute of Scientific and Technical Information of China (English)

    孙若鹏; 赵翠芬

    2008-01-01

    @@ Neurogenic pulmonary edema (NPE) is a type of pulmonary edema that occurs secondary to central nervous sytem (CNS) damage, namely centrogenic pulmonary edema or cerebrogenic pulmonary edema[1,2] NPE is clinically characterized by acute dyspnea and progressive hypoxemia, while tachycardia, hypertension and tachypnea are only nonspecific symptoms in early phase. Early diagnosis of NPE is difficult since chest X-ray shows no remarkable sign or only increased hazy lung markings in early stage[3]. Diagnosis can be made definitely in the late stage of NPE according to the following manifestation : paleness, clamminess, feeling of impending death, rales, frothy pink sputum, hypoxemia and bilateral widespread infiltration on chest roentgenography. However, successful rescue rate is very low and mortality rate could reach as high as 90% at this stage[4-6].

  11. TRPA1 channels mediate acute neurogenic inflammation and pain produced by bacterial endotoxins

    Science.gov (United States)

    Meseguer, Victor; Alpizar, Yeranddy A.; Luis, Enoch; Tajada, Sendoa; Denlinger, Bristol; Fajardo, Otto; Manenschijn, Jan-Albert; Fernández-Peña, Carlos; Talavera, Arturo; Kichko, Tatiana; Navia, Belén; Sánchez, Alicia; Señarís, Rosa; Reeh, Peter; Pérez-García, María Teresa; López-López, José Ramón; Voets, Thomas; Belmonte, Carlos; Talavera, Karel; Viana, Félix

    2014-01-01

    Gram-negative bacterial infections are accompanied by inflammation and somatic or visceral pain. These symptoms are generally attributed to sensitization of nociceptors by inflammatory mediators released by immune cells. Nociceptor sensitization during inflammation occurs through activation of the Toll-like receptor 4 (TLR4) signalling pathway by lipopolysaccharide (LPS), a toxic by-product of bacterial lysis. Here we show that LPS exerts fast, membrane delimited, excitatory actions via TRPA1, a transient receptor potential cation channel that is critical for transducing environmental irritant stimuli into nociceptor activity. Moreover, we find that pain and acute vascular reactions, including neurogenic inflammation (CGRP release) caused by LPS are primarily dependent on TRPA1 channel activation in nociceptive sensory neurons, and develop independently of TLR4 activation. The identification of TRPA1 as a molecular determinant of direct LPS effects on nociceptors offers new insights into the pathogenesis of pain and neurovascular responses during bacterial infections and opens novel avenues for their treatment.

  12. Self-maintenance of neurogenic inflammation contributes to a vicious cycle in skin.

    Science.gov (United States)

    Gouin, Olivier; Lebonvallet, Nicolas; L'Herondelle, Killian; Le Gall-Ianotto, Christelle; Buhé, Virginie; Plée-Gautier, Emmanuelle; Carré, Jean-Luc; Lefeuvre, Luc; Misery, Laurent

    2015-10-01

    Cutaneous neurogenic inflammation (CNI) is frequently associated with skin disorders. CNI is not limited to the retrograde signalling of nociceptive sensory nerve endings but can instead be regarded as a multicellular phenomenon. Thus, soluble mediators participating in communication among sensory nerves, skin and immune cells are key components of CNI. These interactions induce the self-maintenance of CNI, promoting a vicious cycle. Certain G protein-coupled receptors (GPCRs) play a prominent role in these cell interactions and contribute to self-maintenance. Protease-activated receptors 2 and 4 (PAR-2 and PAR-4, respectively) and Mas-related G protein-coupled receptors (Mrgprs) are implicated in the synthesis and release of neuropeptides, proteases and soluble mediators from most cutaneous cells. Regulation of the expression and release of these mediators contributes to the vicious cycle of CNI. The authors propose certain hypothetical therapeutic options to interrupt this cycle, which might reduce skin symptoms and improve patient quality of life.

  13. Traumatic Brain Injury Activation of the Adult Subventricular Zone Neurogenic Niche

    Science.gov (United States)

    Chang, Eun Hyuk; Adorjan, Istvan; Mundim, Mayara V.; Sun, Bin; Dizon, Maria L. V.; Szele, Francis G.

    2016-01-01

    Traumatic brain injury (TBI) is common in both civilian and military life, placing a large burden on survivors and society. However, with the recognition of neural stem cells in adult mammals, including humans, came the possibility to harness these cells for repair of damaged brain, whereas previously this was thought to be impossible. In this review, we focus on the rodent adult subventricular zone (SVZ), an important neurogenic niche within the mature brain in which neural stem cells continue to reside. We review how the SVZ is perturbed following various animal TBI models with regards to cell proliferation, emigration, survival, and differentiation, and we review specific molecules involved in these processes. Together, this information suggests next steps in attempting to translate knowledge from TBI animal models into human therapies for TBI. PMID:27531972

  14. Neurogenic Pulmonary Edema Associated with Underlying Lung Disease after a Breakthrough Seizure

    Directory of Open Access Journals (Sweden)

    Gaurav Dutta

    2012-01-01

    Full Text Available Neurogenic pulmonary edema (NPE can result from various central nervous system disorders such as brain malignancies, traumatic brain injuries, infections, and seizures. Although the pathogenesis is not completely understood, NPE creates an increase in pulmonary interstitial and alveolar fluid. It has been reported with prolonged seizure activity. Treatment for NPE is largely supportive. If unrecognized, it can lead to hypoxia and respiratory arrest. We report a case of NPE in a middle-aged female patient following a breakthrough seizure in whom an immunological cause for respiratory findings was high on the differential list, based on her past medical history and chronicity of symptoms. Rapid symptomatic and radiological improvement following hospitalization led to the correct diagnosis.

  15. Neurogenic bowel dysfunction in patients with spinal cord injury, myelomeningocele, multiple sclerosis and Parkinson's disease

    Institute of Scientific and Technical Information of China (English)

    Richard A Awad

    2011-01-01

    Exciting new features have been described concerning neurogenic bowel dysfunction, including interactions between the central nervous system, the enteric nervous system, axonal injury, neuronal loss, neurotransmission of noxious and non-noxious stimuli, and the fields of gastroenterology and neurology. Patients with spinal cord injury, myelomeningocele, multiple sclerosis and Parkinson's disease present with serious upper and lower bowel dysfunctions characterized by constipation, incontinence, gastrointestinal motor dysfunction and altered visceral sensitivity. Spinal cord injury is associated with severe autonomic dysfunction, and bowel dysfunction is a major physical and psychological burden for these patients. An adult myelomeningocele patient commonly has multiple problems reflecting the multisystemic nature of the disease. Multiple sclerosis is a neurodegenerative disorder in which axonal injury, neuronal loss, and atrophy of the central nervous system can lead to permanent neurological damage and clinical disability. Parkinson's disease is a multisystem disorder involving dopaminergic, noradrenergic, serotoninergic and cholinergic systems, characterized by motor and non-motor symptoms. Parkinson's disease affects several neuronal structures outside the substantia nigra, among which is the enteric nervous system. Recent reports have shown that the lesions in the enteric nervous system occur in very early stages of the disease, even before the involvement of the central nervous system. This has led to the postulation that the enteric nervous system could be critical in the pathophysiology of Parkinson's disease, as it could represent the point of entry for a putative environmental factor to initiate the pathological process. This review covers the data related to the etiology, epidemiology, clinical expression, pathophysiology, genetic aspects, gastrointestinal motor dysfunction, visceral sensitivity, management, prevention and prognosis of neurogenic bowel

  16. Neurogenic vision loss: Causes and outcome. An experience from a tertiary center in Northern India

    Directory of Open Access Journals (Sweden)

    Rajesh Verma

    2014-01-01

    Full Text Available Introduction: Vision loss can be a consequence of numerous disorders of eye and neural pathway conveying visual input to brain. A variety of conditions can affect visual pathway producing neurogenic vision loss. The presentation and course of vision loss depends on the site of involvement and underlying etiology. We conducted this unprecedented study to evaluate the characteristics and outcome of various diseases of the visual pathway. Materials and Methods: In this prospective cohort study, we evaluated 64 patients with neurogenic visual impairment. Ophthalmological causes were excluded in all of them. Their presentation, ophthalmological characteristics and investigation findings were recorded. These patients were followed up till 6 months. Results: Out of 69 patients evaluated, 5 were excluded as they had ophthalmological abnormalities. The remaining 64 cases (113 eyes were enrolled. 54 cases were due to diseases of anterior visual pathway and rest 10 had cortical vision loss. The etiologic distribution is as follows: Isolated optic neuritis- 12 (19%, multiple sclerosis- 4 (6.3%, neuromyelitis optica- 5 (7.9%, tubercular meningitis- 15 (23.8%, non-arteritic ischemic optic neuropathy, ischemic optic neuropathy complicating cavernous sinus thrombosis, cryptococcal meningitis, malignant infiltration of optic nerve, Crouzon′s syndrome, calvarial thickening and traumatic occipital gliosis- 1 (1.6% case each, idiopathic intracranial hypertension, pituitary adenoma, acute disseminated encephalomyelitis, posterior reversible leukoencephalopathy- 3 (4.8% cases each, cortical venous thrombosis 5 (7.9%, subacute scleroing panencephalitis- 4 (6.3% cases. Conclusions: The diseases of anterior visual pathway were much more common than cortical vision loss. A majority of our patients had severe impairment of vision at presentation.

  17. Mesenchymal Stem Cells Secretome as a Modulator of the Neurogenic Niche: Basic Insights and Therapeutic Opportunities

    Directory of Open Access Journals (Sweden)

    Antonio eSalgado

    2015-07-01

    Full Text Available Neural stem cells (NSCs and mesenchymal stem cells (MSCs share few characteristics apart from self-renewal and multipotency. In fact, the neurogenic and osteogenic stem cell niches derive from two distinct embryonary structures; while the later originates from the mesoderm, as all the connective tissues do, the first derives from the ectoderm. Therefore, it is highly unlikely that stem cells isolated from one niche could form terminally differentiated cells from the other. Additionally, these two niches are associated to tissues/systems (e.g bone and central nervous system that have markedly different needs and display diverse functions within the human body. Nevertheless they do share common features. For instance, the differentiation of both NSCs and MSCs is intimately associated with the bone morphogenetic protein family. Moreover, both NSCs and MSCs secrete a panel of common growth factors, such as nerve growth factor (NGF, glial derived neurotrophic factor (GDNF, and brain derived neurotrophic factor (BDNF, among others. But it is not the features they share but the interaction between them that seem most important, and worth exploring; namely, it has already been shown that there are mutually beneficially effects when these cell types are co-cultured in vitro. In fact the use of MSCs, and their secretome, become a strong candidate to be used as a therapeutic tool for CNS applications, namely by triggering the endogenous proliferation and differentiation of neural progenitors, among other mechanisms. Quite interestingly it was recently revealed that MSCs could be found in the human brain, in the vicinity of capillaries. In the present review we highlight how MSCs and NSCs in the neurogenic niches interact. Furthermore, we propose directions on this field and explore the future therapeutic possibilities that may arise from the combination/interaction of MSCs and NSCs.

  18. Neurogenic nitric oxide facilitates the central nociceptive transmission of migraine attacks

    Institute of Scientific and Technical Information of China (English)

    Hebo Wang; Huijun Qi; Shengyuan Yu; Sumian Yang; Ruozhuo Liu

    2011-01-01

    Recent studies have shown that nitric oxide (NO) can induce migraine attacks at three possible sites of action: nitroxidergic nerves, the vascular endothelium, and the central nervous system. Most previous studies have focused on the former two sites of action. Several experiments using exogenic NO donors have suggested that nitroglycerin may induce migraine via central mechanisms. However, few studies have investigated the source of the NO involved in the central mechanisms of migraine. The present study used a cat model of migraine to represent migraine attacks in humans. We performed immunochemical staining of successive frozen sections of the brainstem and upper cervical spinal cord, and then used c-Fos protein expression to label nerve cell activation. We observed the effects of Nω-nitro-L-arginine methyl ester (L-NAME), a non-selective nitric oxide synthase (NOS) inhibitor, and 7-nitroindozole (7-NI), a selective neuronal NOS inhibitor, on c-Fos and nNOS expression, which were induced by electrical stimulation to the dura mater near the superior sagittal sinus. The results demonstrated that c-Fos or nNOS immunoreactive cells was concentrated in the superficial layers (laminae I and II) of the spinal nucleus of trigeminal nerve. L-NAME and 7-NI pre-treatment significantly decreased c-Fos and neurogenic NOS expression; and there was a significant linear correlation between c-Fos and NOS expression (r= 0.858 2, P< 0.01). These findings suggest that neurogenic NO could facilitate migraine nociceptive transmission to second-order neurons of the trigeminal nerve. However, L-NAME and 7-NI may block the activation of neurons in the spinal nucleus of the trigeminal nerve by inhibiting NO synthesis, and thereby attenuate acute migraine attacks.

  19. Stroke increases neural stem cells and angiogenesis in the neurogenic niche of the adult mouse.

    Directory of Open Access Journals (Sweden)

    Rui Lan Zhang

    Full Text Available The unique cellular and vascular architecture of the adult ventricular-subventricular zone (V/SVZ neurogenic niche plays an important role in regulating neural stem cell function. However, the in vivo identification of neural stem cells and their relationship to blood vessels within this niche in response to stroke remain largely unknown. Using whole-mount preparation of the lateral ventricle wall, we examined the architecture of neural stem cells and blood vessels in the V/SVZ of adult mouse over the course of 3 months after onset of focal cerebral ischemia. Stroke substantially increased the number of glial fibrillary acidic protein (GFAP positive neural stem cells that are in contact with the cerebrospinal fluid (CSF via their apical processes at the center of pinwheel structures formed by ependymal cells residing in the lateral ventricle. Long basal processes of these cells extended to blood vessels beneath the ependymal layer. Moreover, stroke increased V/SVZ endothelial cell proliferation from 2% in non-ischemic mice to 12 and 15% at 7 and 14 days after stroke, respectively. Vascular volume in the V/SVZ was augmented from 3% of the total volume prior to stroke to 6% at 90 days after stroke. Stroke-increased angiogenesis was closely associated with neuroblasts that expanded to nearly encompass the entire lateral ventricular wall in the V/SVZ. These data indicate that stroke induces long-term alterations of the neural stem cell and vascular architecture of the adult V/SVZ neurogenic niche. These post-stroke structural changes may provide insight into neural stem cell mediation of stroke-induced neurogenesis through the interaction of neural stem cells with proteins in the CSF and their sub-ependymal neurovascular interaction.

  20. Neurogenic bowel dysfunction in patients with spinal cord injury, myelomeningocele, multiple sclerosis and Parkinson's disease.

    Science.gov (United States)

    Awad, Richard A

    2011-12-14

    Exciting new features have been described concerning neurogenic bowel dysfunction, including interactions between the central nervous system, the enteric nervous system, axonal injury, neuronal loss, neurotransmission of noxious and non-noxious stimuli, and the fields of gastroenterology and neurology. Patients with spinal cord injury, myelomeningocele, multiple sclerosis and Parkinson's disease present with serious upper and lower bowel dysfunctions characterized by constipation, incontinence, gastrointestinal motor dysfunction and altered visceral sensitivity. Spinal cord injury is associated with severe autonomic dysfunction, and bowel dysfunction is a major physical and psychological burden for these patients. An adult myelomeningocele patient commonly has multiple problems reflecting the multisystemic nature of the disease. Multiple sclerosis is a neurodegenerative disorder in which axonal injury, neuronal loss, and atrophy of the central nervous system can lead to permanent neurological damage and clinical disability. Parkinson's disease is a multisystem disorder involving dopaminergic, noradrenergic, serotoninergic and cholinergic systems, characterized by motor and non-motor symptoms. Parkinson's disease affects several neuronal structures outside the substantia nigra, among which is the enteric nervous system. Recent reports have shown that the lesions in the enteric nervous system occur in very early stages of the disease, even before the involvement of the central nervous system. This has led to the postulation that the enteric nervous system could be critical in the pathophysiology of Parkinson's disease, as it could represent the point of entry for a putative environmental factor to initiate the pathological process. This review covers the data related to the etiology, epidemiology, clinical expression, pathophysiology, genetic aspects, gastrointestinal motor dysfunction, visceral sensitivity, management, prevention and prognosis of neurogenic bowel

  1. High-concentration L-menthol exhibits counter-irritancy to neurogenic inflammation, thermal and mechanical hyperalgesia caused by trans-cinnamaldehyde

    DEFF Research Database (Denmark)

    Andersen, Hjalte Holm; Gazerani, Parisa; Arendt-Nielsen, Lars

    2016-01-01

    mechanical hyperalgesia (Pexhibited inhibitory effects on simultaneously established pain, hypersensitivity, and neurogenic inflammation in a human TRPA1-induced pain model. Potent TRPM8-agonists could be useful as topical anti...

  2. The Felix-trial. Double-blind randomization of interspinous implant or bony decompression for treatment of spinal stenosis related intermittent neurogenic claudication

    NARCIS (Netherlands)

    W.A. Moojen (Wouter); M.P. Arts (Mark); R. Brand (René); B.W. Koes (Bart); W.C. Peul (Wilco)

    2010-01-01

    textabstractAbstract. Background. Decompressive laminotomy is the standard surgical procedure in the treatment of patients with canal stenosis related intermittent neurogenic claudication. New techniques, such as interspinous process implants, claim a shorter hospital stay, less post-operative pain

  3. Differences between the neurogenic and proliferative abilities of Müller glia with stem cell characteristics and the ciliary epithelium from the adult human eye

    OpenAIRE

    Bhatia, Bhairavi; Jayaram, Hari; Singhal, Shweta; Jones, Megan F; Limb, G. Astrid

    2011-01-01

    Much controversy has arisen on the nature and sources of stem cells in the adult human retina. Whilst ciliary epithelium has been thought to constitute a source of neural stem cells, a population of Müller glia in the neural retina has also been shown to exhibit neurogenic characteristics. This study aimed to compare the neurogenic and proliferative abilities between these two major cell populations. It also examined whether differences exist between the pigmented and non-pigmented ciliary ep...

  4. Cytoarchitecture and Ultrastructure of Neural Stem Cell Niches and Neurogenic Complexes Maintaining Adult Neurogenesis in the Olfactory Midbrain of Spiny Lobsters, Panulirus argus

    OpenAIRE

    Schmidt, Manfred; Derby, Charles D.

    2011-01-01

    New interneurons are continuously generated in small proliferation zones within neuronal somata clusters in the olfactory deutocerebrum of adult decapod crustaceans. Each proliferation zone is connected to a clump of cells containing one neural stem cell (i.e., adult neuroblast), thus forming a “neurogenic complex.” Here we provide a detailed analysis of the cytoarchitecture of neurogenic complexes in adult spiny lobsters, Panulirus argus, based on transmission electron microscopy and labelin...

  5. Neurogenic bladder evaluation and management after spinal cord injury: Current practice among urologists working in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Waleed Al Taweel

    2011-01-01

    Full Text Available Aim: The aim of this study is to determine the current trends in the management and surveillance of the NB population secondary to spinal cord injury (SCI or myelomeningocele by certified urologist working in Saudi Arabia and to compare it to the current guidelines. Materials and Methods: A cross-sectional study was conducted using a 12-points questionnaire distributed to urologists working in Saudi Arabia and registered at the Saudi medical association. The assessment and follow-up of upper and lower urinary tract function in neurogenic bladder patients, their optimal frequency and management of related infections were the topics of inquiry. Results: Of the 272 urologists surveyed, 105 responded, yielding a response rate of 38%. Eighty-nine percent of respondents said that ultrasound was their diagnostic tool of choice for upper tract evaluation. Sixty-one percent of respondents said that they would follow their patients with a multichannel urodynamic study. Forty percent of urologists stated that they would treat asymptomatic bacteriuria. Clean intermittent catheterization (CIC was the most common modality chosen for the management of neurogenic bladder in patients with emptying difficulties. Conclusion: This study confirms that most urologists in Saudi Arabia involved with neurogenic bladder management. However, more than one third of the urologists do not have urodynamic machine and only two of the reporting practitioners has a videourodynamic machine. The results emphasize the need for clear guidelines in this field of urology in Saudi Arabia. Highly specialized rehabilitation centers for neurogenic bladder secondary to SCI are required for optimal care and urologist teaching.

  6. Neurogenic bowel dysfunction in patients with spinal cord injury, myelomeningocele, multiple sclerosis and Parkinson’s disease

    OpenAIRE

    Richard A. Awad

    2011-01-01

    Exciting new features have been described concerning neurogenic bowel dysfunction, including interactions between the central nervous system, the enteric nervous system, axonal injury, neuronal loss, neurotransmission of noxious and non-noxious stimuli, and the fields of gastroenterology and neurology. Patients with spinal cord injury, myelomeningocele, multiple sclerosis and Parkinson’s disease present with serious upper and lower bowel dysfunctions characterized by constipation, incontinenc...

  7. The Role of Brain-Derived Neurotrophic Factor (BDNF) in the Development of Neurogenic Detrusor Overactivity (NDO)

    OpenAIRE

    Frias, Bárbara; Santos, João; Morgado, Marlene; Sousa, Mónica Mendes; Gray, Susannah M Y; McCloskey, Karen; Allen, Shelley; Cruz, Francisco; Cruz, Célia Duarte

    2015-01-01

    Neurogenic detrusor overactivity (NDO) is a well known consequence of spinal cord injury (SCI), recognizable after spinal shock, during which the bladder is areflexic. NDO emergence and maintenance depend on profound plastic changes of the spinal neuronal pathways regulating bladder function. It is well known that neurotrophins (NTs) are major regulators of such changes. NGF is the best-studied NT in the bladder and its role in NDO has already been established. Another very abundant neurotrop...

  8. Harnableitung bei Kindern und Jugendlichen mit neurogener Blasenfunktionsstörung: auch langfristig eine sichere Therapieoption?

    Directory of Open Access Journals (Sweden)

    Stein R

    2002-01-01

    Full Text Available Einleitung: Pharmakotherapie, der saubere Einmalkatheterismus (clean intermittent catheterization = CIC und die Infektionsprophylaxe sind die drei Säulen der konservativen Therapie bei Patienten mit neurogener Blasenfunktionsstörung. Während der Pubertät werden die Patienten zunehmend unabhängiger vom Elternhaus. Gleichzeitig nimmt jedoch die Compliance der Medikamenteneinnahme und der Durchführung des regelmäßigen CIC ab. Der orthopädische und/oder neurologische Status kann sich ebenfalls verändern. Dies kann letztlich zum Fehlschlagen der konservativen Therapie (Inkontinenz, Restharn, Verschlechterung der Funktion des oberen Harntraktes führen. In einem multidisziplinären Team wird diese Problematik der Kinder und Jugendlichen unter Berücksichtigung der Wünsche des Patienten als auch der medizinischen Ziele (z. B. Schutz der Nierenfunktion in unserer Klinik diskutiert. Die Harnableitung wurde hierbei in einigen Fällen als notwendige Kompromißlösung angesehen. In der vorliegenden retrospektiven Studie untersuchten wir, ob die Harnableitung auch langfristig ein sicheres Verfahren darstellt. Material und Methode: Zwischen 1967 und 1997 erfolgte bei 149 Kindern und Heranwachsenden die Anlage einer Harnableitung. 129 Patienten konnten durchschnittlich 11,8 Jahre (0,8-28,5 nachbeobachtet werden. Das durchschnittliche Alter bei der Operation betrug 12,1 Jahre (0,8-20. Ein Colon-Conduit wurde bei 59 Patienten (in der Mehrzahl der Fälle vor der Ära des CIC und der kontinenten Harnableitung angelegt, eine orthotope Blasensubstitution erfolgte bei 12, eine kontinente kutane Harnableitung bei 58 Patienten (50 % Rollstuhlfahrer. Ergebnisse: Der obere Harntrakt blieb bei 95-97 % der renoureteralen Einheiten (RUE stabil, bzw. verbesserte sich. Alle Patienten mit einer orthotopen Blasensubstitution sind tagsüber kontinent; eine Patientin benötigt zur Sicherheit zeitweise eine Vorlage während der Nacht. 7 der 12 Patienten führen einen

  9. Potential Therapies by Stem Cell-Derived Exosomes in CNS Diseases: Focusing on the Neurogenic Niche

    Directory of Open Access Journals (Sweden)

    Alejandro Luarte

    2016-01-01

    Full Text Available Neurodegenerative disorders are one of the leading causes of death and disability and one of the biggest burdens on health care systems. Novel approaches using various types of stem cells have been proposed to treat common neurodegenerative disorders such as Alzheimer’s Disease, Parkinson’s Disease, or stroke. Moreover, as the secretome of these cells appears to be of greater benefit compared to the cells themselves, the extracellular components responsible for its therapeutic benefit have been explored. Stem cells, as well as most cells, release extracellular vesicles such as exosomes, which are nanovesicles able to target specific cell types and thus to modify their function by delivering proteins, lipids, and nucleic acids. Exosomes have recently been tested in vivo and in vitro as therapeutic conveyors for the treatment of diseases. As such, they could be engineered to target specific populations of cells within the CNS. Considering the fact that many degenerative brain diseases have an impact on adult neurogenesis, we discuss how the modulation of the adult neurogenic niches may be a therapeutic target of stem cell-derived exosomes. These novel approaches should be examined in cellular and animal models to provide better, more effective, and specific therapeutic tools in the future.

  10. Regionally-specified second trimester fetal neural stem cells reveals differential neurogenic programming.

    Directory of Open Access Journals (Sweden)

    Yiping Fan

    Full Text Available Neural stem/progenitor cells (NSC have the potential for treatment of a wide range of neurological diseases such as Parkinson Disease and multiple sclerosis. Currently, NSC have been isolated only from hippocampus and subventricular zone (SVZ of the adult brain. It is not known whether NSC can be found in all parts of the developing mid-trimester central nervous system (CNS when the brain undergoes massive transformation and growth. Multipotent NSC from the mid-trimester cerebra, thalamus, SVZ, hippocampus, thalamus, cerebellum, brain stem and spinal cord can be derived and propagated as clonal neurospheres with increasing frequencies with increasing gestations. These NSC can undergo multi-lineage differentiation both in vitro and in vivo, and engraft in a developmental murine model. Regionally-derived NSC are phenotypically distinct, with hippocampal NSC having a significantly higher neurogenic potential (53.6% over other sources (range of 0%-27.5%, p<0.004. Whole genome expression analysis showed differential gene expression between these regionally-derived NSC, which involved the Notch, epidermal growth factor as well as interleukin pathways. We have shown the presence of phenotypically-distinct regionally-derived NSC from the mid-trimester CNS, which may reflect the ontological differences occurring within the CNS. Aside from informing on the role of such cells during fetal growth, they may be useful for different cellular therapy applications.

  11. Regionally-specified second trimester fetal neural stem cells reveals differential neurogenic programming.

    Science.gov (United States)

    Fan, Yiping; Marcy, Guillaume; Lee, Eddy S M; Rozen, Steve; Mattar, Citra N Z; Waddington, Simon N; Goh, Eyleen L K; Choolani, Mahesh; Chan, Jerry K Y

    2014-01-01

    Neural stem/progenitor cells (NSC) have the potential for treatment of a wide range of neurological diseases such as Parkinson Disease and multiple sclerosis. Currently, NSC have been isolated only from hippocampus and subventricular zone (SVZ) of the adult brain. It is not known whether NSC can be found in all parts of the developing mid-trimester central nervous system (CNS) when the brain undergoes massive transformation and growth. Multipotent NSC from the mid-trimester cerebra, thalamus, SVZ, hippocampus, thalamus, cerebellum, brain stem and spinal cord can be derived and propagated as clonal neurospheres with increasing frequencies with increasing gestations. These NSC can undergo multi-lineage differentiation both in vitro and in vivo, and engraft in a developmental murine model. Regionally-derived NSC are phenotypically distinct, with hippocampal NSC having a significantly higher neurogenic potential (53.6%) over other sources (range of 0%-27.5%, pcells during fetal growth, they may be useful for different cellular therapy applications.

  12. Potential Therapies by Stem Cell-Derived Exosomes in CNS Diseases: Focusing on the Neurogenic Niche

    Science.gov (United States)

    Luarte, Alejandro; Bátiz, Luis Federico; Wyneken, Ursula; Lafourcade, Carlos

    2016-01-01

    Neurodegenerative disorders are one of the leading causes of death and disability and one of the biggest burdens on health care systems. Novel approaches using various types of stem cells have been proposed to treat common neurodegenerative disorders such as Alzheimer's Disease, Parkinson's Disease, or stroke. Moreover, as the secretome of these cells appears to be of greater benefit compared to the cells themselves, the extracellular components responsible for its therapeutic benefit have been explored. Stem cells, as well as most cells, release extracellular vesicles such as exosomes, which are nanovesicles able to target specific cell types and thus to modify their function by delivering proteins, lipids, and nucleic acids. Exosomes have recently been tested in vivo and in vitro as therapeutic conveyors for the treatment of diseases. As such, they could be engineered to target specific populations of cells within the CNS. Considering the fact that many degenerative brain diseases have an impact on adult neurogenesis, we discuss how the modulation of the adult neurogenic niches may be a therapeutic target of stem cell-derived exosomes. These novel approaches should be examined in cellular and animal models to provide better, more effective, and specific therapeutic tools in the future. PMID:27195011

  13. Blunt cavernous nerve injury: A new animal model mimicking postradical prostatectomy neurogenic impotence.

    Science.gov (United States)

    Karakiewicz, P I; Bazinet, M; Zvara, P; Begin, L R; Brock, G B

    1996-01-01

    Our goal was to develop an animal model of cavernous nerve injury similar to that encountered among patients having undergone a successful nerve sparing radical prostatectomy and to compare patterns of nicotinamide adenine dinucleotide phosphate (NADPH)-diaphorase staining to quality of erections using the newly developed model. We studied 50 mature Sprague Dawley rats, which were divided into five equal groups. Animals were either observed (sham), underwent an exploratory laparotomy, underwent moderate or severe percussive injury to both cavernous nerves, or underwent ablation of both cavernous nerves. Between 28 and 30 days later, all animals underwent electrostimulation and simultaneous recording of intracavernosal pressure. After sacrifice, penes were harvested and penile tissue NADPH-diaphorase staining pattern was assessed. Severity of cavernous nerve percussive injury and NADPH-diaphorase staining patterns correlated with the quality of recorded erections. This model is a useful experimental tool for research in the field of erectile dysfunction such as is encountered following a successful nerve sparing radical prostatectomy. Penile biopsy assessing NADPH-diaphorase staining may potentially prove to be a useful minimally-invasive diagnostic modality quantifying neurogenic erectile function among patients following radical prostatectomy. PMID:21224162

  14. Estrogen treatment enhances neurogenic differentiation of human adipose derived stem cells in vitro

    Science.gov (United States)

    Razavi, Shahnaz; Razavi, Mohamad Reza; Ahmadi, Nafiseh; Kazemi, Mohammad

    2015-01-01

    Objective(s): Estrogen is a sexual hormone that has prominent effects on reproductive and non-reproductive tissues. The aim of this study is to evaluate the effects of estrogen on the proliferation and neural differentiation of human adipose derived stem cells (ADSCs) during neurogenic differentiation. Materials and Methods: Isolated human ADSCs were trans-differentiated in neural induction medium containing neurobasal medium, N2 and B27 with or without 17β-estradiol (E2) treatment. Proliferation rate and neural differentiation of human ADSCs were assessed using MTT assay, immunostaining and real time RT- PCR analysis, respectively. Results: Analysis of data show that estradiol treatment can significantly increase proliferation rate of differentiated cells (P<0.05). Immunocytochemical and real time RT-PCR analysis revealed that the expression of precursor and mature neuronal markers (nestin and MAP2) was significantly higher in the E2 treated cell cultures when compared to the untreated cell cultures (P<0.05). Conclusion: According to our findings, estrogen can promote proliferation and neuronal differentiation of human ADSCs. PMID:26557969

  15. Neurogenic plasticity of mesenchymal stem cell, an alluring cellular replacement for traumatic brain injury.

    Science.gov (United States)

    Pati, Soumya; Muthuraju, Sangu; Hadi, Raisah Ab; Huat, Tee Jong; Singh, Shailja; Maletic-Savatic, Mirjana; Abdullah, Jafri Malin; Jaafar, Hasnan

    2016-01-01

    Traumatic brain injury (TBI) imposes horrendous neurophysiological alterations leading to most devastating forms of neuro-disability. Which includes impaired cognition, distorted locomotors activity and psychosomatic disability in both youths and adults. Emerging evidence from recent studies has identified mesenchymal stem cells (MSCs) as one of the promising category of stem cells having excellent neuroregenerative capability in TBI victims. Some of the clinical and animal studies reported that MSCs transplantation could cure neuronal damage as well as improve cognitive and locomotors behaviors in TBI. However, mechanism behind their broad spectrum neuroregenerative potential in TBI has not been reviewed yet. Therefore, in the present article, we present a comprehensive data on the important attributes of MSCs, such as neurotransdifferentiation, neuroprotection, axonal repair and plasticity, maintenance of blood-brain integrity, reduction of reactive oxygen species (ROS) and immunomodulation. We have reviewed in detail the crucial neurogenic capabilities of MSCs in vivo and provided consolidated knowledge regarding their cellular remodeling in TBI for future therapeutic implications. PMID:26763886

  16. Compilation of a preliminary checklist for the differential diagnosis of neurogenic stuttering

    Directory of Open Access Journals (Sweden)

    Mariska Lundie

    2014-06-01

    Full Text Available Background: Neurogenic stuttering (NS is the most frequently occurring acquired form of stuttering in children and adults. This form of stuttering is primarily caused by neurological incidents. Owing to controversies with regard to similarities between developmental stuttering (DS and NS symptomatology, differential diagnosis is problematic. Differential diagnosis will guide the appropriate management of persons who stutter (PWS.Objectives: The aim of this study was to describe and highlight the characteristics of NS in order to compile a preliminary checklist for accurate diagnosis and intervention.Method: An explorative, applied mixed method, multiple case study research design was followed. Purposive sampling was used to select four participants. A comprehensive assessment battery was compiled for data collection.Results: The results revealed a distinct pattern of core stuttering behaviours in NS, although discrepancies existed regarding stuttering severity and frequency. It was also found that DS and NS can co-occur. The case history and the core stuttering pattern are important considerations during differential diagnosis, as these are the only consistent characteristics in people with NS.Conclusion: It is unlikely that all the symptoms of NS are present in an individual. The researchers scrutinised the findings of this study and the findings of previous literature to compile a potentially workable checklist.

  17. Potential neurogenic and vascular roles of nitric oxide in migraine headache and aura.

    Science.gov (United States)

    Myers, D E

    1999-02-01

    It has long been known that nitrate and nitrite medications consistently cause significant headache as a side effect. Classical research has shown that cerebral vasodilation accompanies the use of these medications. More modern studies suggest that these vasodilators exert their action on blood vessels via nitric oxide and its second messenger, cyclic guanosine monophosphate. This paper reviews research studies and theoretical articles which address the concept that nitric oxide plays a major role in the vasodilation associated with the headache phase of migraine with aura. A brief discussion of nitric oxide biochemistry and pharmacology follows. In addition, there is a review of evidence examining the possible contributions of nitric oxide to the neurogenic and vascular events associated with spreading cortical depression, an animal model of migraine aura. The paradoxical hypotheses that nitric oxide may contribute to both the propagation of spreading cortical depression and its limitation are presented. Finally, a rationale for the experimental use of nitric oxide agonists and antagonists in the abortion of migraine aura is introduced. PMID:15613204

  18. A step-wise approach to sperm retrieval in men with neurogenic anejaculation.

    Science.gov (United States)

    Fode, Mikkel; Ohl, Dana A; Sønksen, Jens

    2015-11-01

    Normal fertility is dependent on intravaginal delivery of semen through ejaculation. This process is highly dependent on an intact ejaculatory reflex arc, which can be disrupted through any type of trauma or disease causing damage to the CNS and/or peripheral nerves. Neurogenic anejaculation is most commonly associated with spinal cord injury. This aetiology is especially relevant because most men with spinal cord injuries are injured at reproductive age. Assisted ejaculation in the form of penile vibratory stimulation is the first choice for sperm retrieval in such patients because it is noninvasive and inexpensive. In patients in whom vibratory stimulation fails, electroejaculation is almost always successful. When both methods of assisted ejaculation are unsuccessful, sperm retrieval by aspiration from either the vas deferens or the epididymis, or by testicular biopsy or surgery are reasonable options. In such cases the most inexpensive and least invasive methods should be considered first. The obtained semen can be used for intravaginal or intrauterine insemination or in vitro fertilization with or without intracytoplasmic sperm injection. PMID:26481575

  19. Neural histamine in the tuberomammillary nucleus regulates the onset of neurogenic pulmonary edema in rabbits

    Institute of Scientific and Technical Information of China (English)

    Rong Dong; Xiaohong Zhang; Lijuan Shi

    2009-01-01

    Objective:To explore the effect of neural histamine in the tuberomammillary nucleus(TM) on neurogenic pulmonary edema (NPE) onset in rabbits and the function of the rostral ventrolateral medulla(RVLM) in the neural histamine modulation of NPE.Methods:NPE was produced by the intracisternal injections of fibrinogen and thrombin.The contents of histamine in the TM and RVLM in rabbits were measured with high performance liquid chromatography(HPLC).Rabbits were placed on a stereotaxic frame and microinjection cannulae were inserted into the TM and RVLM using brain atlas coordinates.Animals were pretreated with R-α-methylhistamine(MeHA) in the TM and chlorphenamine Mmaleate/cimetidine in the RVLM prior to establishing the NPE model.Changes in the lung water ratio and mean arterial pressure(MAP) were recorded,and paraffin sections of lung tissue were observed by light microscope.Results:We found that the contents of histamine(HA) in the TM and RVLM increased significantly with the onset of NPE.Pretreatment with MeHA in the TM and chlorphenamine Mmaleate in the RVLM significantly decreased MAP,and the lung water ratio and histological characteristics of the NPE in the rabbit model.Pretreatment with cimetidine in the RVLM had no effect on NPE.Conculsion:The results suggest that neural histamine in the TM is involved in the onset of NPE,and this effect of neural histamine is mediated by H receptor in the RVLM.

  20. Conversion of MyoD to a Neurogenic Factor: Binding Site Specificity Determines Lineage

    Directory of Open Access Journals (Sweden)

    Abraham P. Fong

    2015-03-01

    Full Text Available MyoD and NeuroD2, master regulators of myogenesis and neurogenesis, bind to a “shared” E-box sequence (CAGCTG and a “private” sequence (CAGGTG or CAGATG, respectively. To determine whether private-site recognition is sufficient to confer lineage specification, we generated a MyoD mutant with the DNA-binding specificity of NeuroD2. This chimeric mutant gained binding to NeuroD2 private sites but maintained binding to a subset of MyoD-specific sites, activating part of both the muscle and neuronal programs. Sequence analysis revealed an enrichment for PBX/MEIS motifs at the subset of MyoD-specific sites bound by the chimera, and point mutations that prevent MyoD interaction with PBX/MEIS converted the chimera to a pure neurogenic factor. Therefore, redirecting MyoD binding from MyoD private sites to NeuroD2 private sites, despite preserved binding to the MyoD/NeuroD2 shared sites, is sufficient to change MyoD from a master regulator of myogenesis to a master regulator of neurogenesis.

  1. A clinically authentic mouse model of enterovirus 71 (EV-A71)-induced neurogenic pulmonary oedema.

    Science.gov (United States)

    Victorio, Carla Bianca Luena; Xu, Yishi; Ng, Qimei; Chua, Beng Hooi; Alonso, Sylvie; Chow, Vincent T K; Chua, Kaw Bing

    2016-01-01

    Enterovirus 71 (EV-A71) is a neurotropic virus that sporadically causes fatal neurologic illness among infected children. Animal models of EV-A71 infection exist, but they do not recapitulate in animals the spectrum of disease and pathology observed in fatal human cases. Specifically, neurogenic pulmonary oedema (NPE)-the main cause of EV-A71 infection-related mortality-is not observed in any of these models. This limits their utility in understanding viral pathogenesis of neurologic infections. We report the development of a mouse model of EV-A71 infection displaying NPE in severely affected animals. We inoculated one-week-old BALB/c mice with an adapted EV-A71 strain and identified clinical signs consistent with observations in human cases and other animal models. We also observed respiratory distress in some mice. At necropsy, we found their lungs to be heavier and incompletely collapsed compared to other mice. Serum levels of catecholamines and histopathology of lung and brain tissues of these mice strongly indicated onset of NPE. The localization of virally-induced brain lesions also suggested a potential pathogenic mechanism for EV-A71-induced NPE. This novel mouse model of virally-induced NPE represents a valuable resource for studying viral mechanisms of neuro-pathogenesis and pre-clinical testing of potential therapeutics and prophylactics against EV-A71-related neurologic complications. PMID:27357918

  2. Neurogenic stuttering as a manifestation of stroke and a mask of dysphonia.

    Science.gov (United States)

    Rao, P R

    1991-01-01

    R. L. was a 52-year-old man who was referred for an SLP consultation to determine the nature of his fluency disorder, whether or not treatment would be beneficial, and finally whether resumption of pre-trauma vocational status was feasible. The patient was involved in a motor vehicle accident with no resulting detectable trauma. However, shortly after the accident, R. L. developed a severe dysfluency that was later described as cortical stuttering. We reviewed the medical and rehabilitation work-up that attempted to determine whether the communication disorder was functional or organic in origin. Once the fluency disorder was determined to be caused by a suspected small, focal, hemispheric lesion, a five-month treatment program was undertaken that used a noval prosthetic approach to restore fluency. Once fluency was restored with the use of an artificial larynx, a residual anomia was detected and treated. The case of R. L. illustrates a stuttering that appeared to be caused by a combined neurogenic dyspraxic (vocal control), dysarthric (motor control), and dysnomic (word-finding) dysfluency. The literature on this issue was reviewed and the underlying mechanism of recovery was discussed.

  3. Neurogenic differentiation factor NeuroD confers protection against radiation-induced intestinal injury in mice.

    Science.gov (United States)

    Li, Ming; Du, Aonan; Xu, Jing; Ma, Yanchao; Cao, Han; Yang, Chao; Yang, Xiao-Dong; Xing, Chun-Gen; Chen, Ming; Zhu, Wei; Zhang, Shuyu; Cao, Jianping

    2016-01-01

    The gastrointestinal tract, especially the small intestine, is particularly sensitive to radiation, and is prone to radiation-induced injury as a result. Neurogenic differentiation factor (NeuroD) is an evolutionarily-conserved basic helix-loop-helix (bHLH) transcription factor. NeuroD contains a protein transduction domain (PTD), which allows it to be exogenously delivered across the membrane of mammalian cells, whereupon its transcription activity can be unleashed. Whether NeuroD has therapeutic effects for radiation-induced injury remains unclear. In the present study, we prepared a NeuroD-EGFP recombinant protein, and explored its protective effects on the survival and intestinal damage induced by ionizing radiation. Our results showed that NeuroD-EGFP could be transduced into small intestine epithelial cells and tissues. NeuroD-EGFP administration significantly increased overall survival of mice exposed to lethal total body irradiation (TBI). This recombinant NeuroD also reduced radiation-induced intestinal mucosal injury and apoptosis, and improved crypt survival. Expression profiling of NeuroD-EGFP-treated mice revealed upregulation of tissue inhibitor of metalloproteinase 1 (TIMP-1), a known inhibitor of apoptosis in mammalian cells. In conclusion, NeuroD confers protection against radiation-induced intestinal injury, and provides a novel therapeutic clinical option for the prevention of intestinal side effects of radiotherapy and the treatment of victims of incidental exposure. PMID:27436572

  4. CIT, a gene involved in neurogenic cytokinesis, is mutated in human primary microcephaly.

    Science.gov (United States)

    Basit, Sulman; Al-Harbi, Khalid M; Alhijji, Sabri A M; Albalawi, Alia M; Alharby, Essa; Eldardear, Amr; Samman, Mohammed I

    2016-10-01

    Autosomal recessive primary microcephaly (MCPH) is a static neurodevelopmental disorder characterized by congenital small head circumference and non-progressive intellectual disability without additional severe brain malformations. MCPH is a genetically heterogeneous disorder. Sixteen genes (MCPH1-MCPH16) have been discovered so far, mutations thereof lead to autosomal recessive primary microcephaly. In a family, segregating MCPH in an autosomal recessive manner, genome-wide homozygosity mapping mapped a disease locus to 16.9-Mb region on chromosome 12q24.11-q24.32. Following this, exome sequencing in three affected individuals of the family discovered a splice site variant (c.753+3A>T) in citron kinase (CIT) gene, segregating with the disorder in the family. CIT co-localizes to the midbody ring during cytokinesis, and its loss of expression results in defects in neurogenic cytokinesis in both humans and mice. Splice site variant in CIT, identified in this study, is predicted to abolish splice donor site. cDNA sequence of an affected individual showed retention of an intron next to the splice donor site. The study, presented here, revealed the first variant in the CIT causing MCPH in the family. PMID:27519304

  5. MDM2 inhibition rescues neurogenic and cognitive deficits in a mouse model of fragile X syndrome.

    Science.gov (United States)

    Li, Yue; Stockton, Michael E; Bhuiyan, Ismat; Eisinger, Brian E; Gao, Yu; Miller, Jessica L; Bhattacharyya, Anita; Zhao, Xinyu

    2016-04-27

    Fragile X syndrome, the most common form of inherited intellectual disability, is caused by loss of the fragile X mental retardation protein (FMRP). However, the mechanism remains unclear, and effective treatment is lacking. We show that loss of FMRP leads to activation of adult mouse neural stem cells (NSCs) and a subsequent reduction in the production of neurons. We identified the ubiquitin ligase mouse double minute 2 homolog (MDM2) as a target of FMRP. FMRP regulates Mdm2 mRNA stability, and loss of FMRP resulted in elevated MDM2 mRNA and protein. Further, we found that increased MDM2 expression led to reduced P53 expression in adult mouse NSCs, leading to alterations in NSC proliferation and differentiation. Treatment with Nutlin-3, a small molecule undergoing clinical trials for treating cancer, specifically inhibited the interaction of MDM2 with P53, and rescued neurogenic and cognitive deficits in FMRP-deficient mice. Our data reveal a potential regulatory role for FMRP in the balance between adult NSC activation and quiescence, and identify a potential new treatment for fragile X syndrome. PMID:27122614

  6. Genetic Evaluation of E. coli Strains Isolated from Asymptomatic Children with Neurogenic Bladders

    Directory of Open Access Journals (Sweden)

    John Kryger

    2015-01-01

    Full Text Available This study was conducted to describe the genetic profiles of E. coli that colonize asymptomatic pediatric neurogenic bladders. E. coli was isolated from 25 of 80 urine samples. Patients were excluded if they presented with symptomatic urinary tract infection or received treatment with antibiotics in the preceding three months. Multiplex PCR was performed to determine E. coli phylotype (A, B1, B2, and D and the presence of seven pathogenicity islands (PAIs and 10 virulence factors (VFs. E. coli strains were predominantly of the B1 and B2 phylotype, with few strains in the A or D phylotype. The PAIs IV536, ICFT073, and IICFT073 had the highest prevalence: 76%, 64%, and 48%, respectively. The PAIs II536, IJ96, and IIJ96 were less prevalent: 28%, 20%, and 24%, respectively. The most prevalent VF was vat (40%, while the least prevalent VFs were sfa (8% and iha (12%. None of the strains carried the VF fyuA, which is very common in uropathogenic E. coli (UPEC. The genetic profiles of E. coli in this cohort seem to be more similar to UPEC than to commensal E. coli. However, they appear to have reduced virulence potential that allows them to colonize asymptomatically.

  7. Heated indoor swimming pools, infants, and the pathogenesis of adolescent idiopathic scoliosis: a neurogenic hypothesis

    Directory of Open Access Journals (Sweden)

    McMaster Marianne E

    2011-10-01

    Full Text Available Abstract Background In a case-control study a statistically significant association was recorded between the introduction of infants to heated indoor swimming pools and the development of adolescent idiopathic scoliosis (AIS. In this paper, a neurogenic hypothesis is formulated to explain how toxins produced by chlorine in such pools may act deleteriously on the infant's immature central nervous system, comprising brain and spinal cord, to produce the deformity of AIS. Presentation of the hypothesis Through vulnerability of the developing central nervous system to circulating toxins, and because of delayed epigenetic effects, the trunk deformity of AIS does not become evident until adolescence. In mature healthy swimmers using such pools, the circulating neurotoxins detected are chloroform, bromodichloromethane, dibromochloromethane, and bromoform. Cyanogen chloride and dichloroacetonitrile have also been detected. Testing the hypothesis In infants, the putative portals of entry to the blood could be dermal, oral, or respiratory; and entry of such circulating small molecules to the brain are via the blood-brain barrier, blood-cerebrospinal fluid barrier, and circumventricular organs. Barrier mechanisms of the developing brain differ from those of adult brain and have been linked to brain development. During the first 6 months of life cerebrospinal fluid contains higher concentrations of specific proteins relative to plasma, attributed to mechanisms continued from fetal brain development rather than immaturity. Implications of the hypothesis The hypothesis can be tested. If confirmed, there is potential to prevent some children from developing AIS.

  8. The anatomical basis and prevention of neurogenic voiding dysfunction following radical hysterectomy.

    Science.gov (United States)

    Tong, X K; Huo, R J

    1991-01-01

    The disorder of neurogenic dysfunction is one of the most important complications of radical hysterectomy. In order to prevent this potential complication, the authors have studied the composition and layers of the pelvic paravisceral structures. The nerve branching and distribution of the pelvic plexus of 12 adult female cadavers were analyzed. From lateral to medial the pelvic paravisceral structure is made up of three layers. The lateral layer is the pelvic visceral fascia, the middle, a vascular layer, and the medial one, a nervous one which consists of the pelvic plexus and subsidiary plexuses. The pelvic plexus and subsidiary plexuses are laid closely to the lateral walls of pelvic organs. The ischial spine was taken as the central point and two perpendicular lines penetrating through the ischial spine were used as the longitudinal axis and transverse axis. According to these landmarks, the pelvic plexus could be divided into three parts: behind the longitudinal axis are the roots of the pelvic plexus, near the longitudinal axis is the uterovaginal plexus, and in front of the longitudinal axis are the branches distributed to bladder and urethra. The pelvic plexus and the uterosacral and cardinal ligaments are closely related. The pelvic and subsidiary plexuses can be damaged in radical hysterectomy and voiding dysfunction may then develop. Some anatomic bases are provided to explain and hopefully prevent this from happening. PMID:1925917

  9. Neurogenic orthostatic hypotension in Parkinson's disease: evaluation, management, and emerging role of droxidopa.

    Science.gov (United States)

    Isaacson, Stuart H; Skettini, Julia

    2014-01-01

    Neurogenic orthostatic hypotension (nOH) is due to failure of the autonomic nervous system to regulate blood pressure in response to postural changes due to an inadequate release of norepinephrine, leading to orthostatic hypotension and supine hypertension. nOH is common in Parkinson's disease (PD). Prevalence varies throughout the course of PD, ranging from 40% to 60%, and resulting in symptomatic nOH in approximately half. Symptomatic nOH, including lightheadedness, can limit daily activities and lead to falls. Symptomatic nOH can also limit therapeutic options for treating PD motor symptoms. Clinical evaluation should routinely include symptom assessment and blood pressure measurement of supine, sitting, and 3-minute standing; 24-hour ambulatory blood pressure monitoring can also be helpful. Non-pharmacological management of symptomatic nOH involves education, physical maneuvers, and adequate hydration. Current pharmacological treatment of symptomatic nOH includes salt supplement, fludrocortisone, midodrine, pyridostigmine, and other empiric medications. Despite these options, treatment of symptomatic nOH remains suboptimal, often limited by severe increases in supine blood pressure. Droxidopa, an oral prodrug converted by decarboxylation to norepinephrine, is a promising therapeutic option for symptomatic nOH in PD, improving symptoms of nOH, daily activities, falls, and standing systolic blood pressure in several recent trials. These trials demonstrated short-term efficacy and tolerability, with comparable increases in standing and supine blood pressures. Longer-term studies are ongoing to confirm durability of treatment effect.

  10. 18F-Sodium Fluoride PET-CT Hybrid Imaging of the Lumbar Facet Joints: Tracer Uptake and Degree of Correlation to CT-graded Arthropathy

    Science.gov (United States)

    Mabray, Marc C.; Brus-Ramer, Marcel; Behr, Spencer C.; Pampaloni, Miguel H.; Majumdar, Sharmila; Dillon, William P.; Talbott, Jason F.

    2016-01-01

    We aim to evaluate 18F-NaF uptake by facet joints with hybrid PET-CT technique. Specifically, we evaluate NaF uptake in the facet joints of the lower lumbar spine, and correlate with the morphologic grade of facet arthropathy on CT. 30 consecutive patients who underwent standard vertex to toes NaF PET-CT for re-staging of primary neoplastic disease without measurable or documented bony metastases were identified. Maximum (SUVmax) and average (SUVavg) standardized uptake values were calculated for each L3-4, L4-5, and L5-S1 facet joint (n = 180) and normalized to average uptake in the non-diseased femur. A Pathria grade (0-3) was assigned to each facet based upon the CT morphology. Spearman's rank correlation was performed for normalized SUVmax and SUVavg with Pathria grade. ANOVA was performed with Tukey-Kramer pairwise tests to evaluate differences in uptake between Pathria groups. Facet normalized SUVmax (r = 0.31, P < 0.001) and SUVavg (r = 0.28, P < 0.001) demonstrated a mild positive correlation with CT Pathria grade. There was a wide range of uptake values within each Pathria grade subgroup with statistically significant differences in uptake only between Pathria grade 3 as compared to grades 0, 1, and 2. In conclusion, NaF uptake and morphologic changes of the facet joint on CT are weakly correlated. Physiologic information provided by NaF uptake is often discrepant with structural findings on CT suggesting NaF PET may supplement conventional structural imaging for identification of pain generating facet joints. Prospective investigation into the relationship of facet joint NaF uptake with pain and response to pain interventions is warranted. PMID:27134557

  11. Sciatic nerve compression by neurogenic heterotopic ossification: use of CT to determine surgical indications

    International Nuclear Information System (INIS)

    To describe the characteristics of neurogenic heterotopic ossification (NHO) based on clinical tests, electroneuromyography (ENMG) and CT in a database of patients with lesions of the central nervous system who required sciatic nerve neurolysis along with posterior hip NHO resection, and to determine the respective roles of ENMG and CT in the management of posterior hip NHOs in patients who are unable to communicate or express pain. The consistency of the ENMG results with clinical findings, CT results and macroscopic signs of lesions was retrospectively assessed after sciatic nerve neurolysis and ablation of 55 posterior hip NHOs. Sciatic nerve neurolysis was necessary in 55 cases (47.4 %; 55 out of 116). CT showed contact of the NHO with the nerve in all cases: 5 in contact with no deflection, 3 in contact with deflection, 21 moulded into a gutter and 26 entrapped in the NHO. There were clinical signs of sciatic nerve lesion in 21.8 % of cases (12 out of 55). ENMG showed signs of sciatic nerve lesions in only 55.6 % (10 out of 18), only 4 of whom presented with clinical signs of a nerve lesion. No significant relationship was found between clinical symptoms and ENMG findings of sciatic nerve compression (n = 13, p = 0.77). Nerve compression by NHO is likely an underdiagnosed condition, particularly in patients who are unable to communicate. Diagnosis of sciatic compression by NHO should be based on regular clinical examinations and CT. ENMG is not sufficiently sensitive to be used alone for surgical decision-making. (orig.)

  12. Benign and malignant neurogenic tumors of nerve sheath origin on FDG PET

    Energy Technology Data Exchange (ETDEWEB)

    Yun, M. J.; Go, D. H.; Yoo, Y. H.; Shin, K. H.; Lee, J. D [College of Medicine, Yonsei University, Seoul (Korea, Republic of)

    2004-07-01

    The differentiation between benign and malignant nerve sheath tumors is difficult based on conventional radiological imaging. This study was undertaken to investigate the value of FDG PET in distinguishing benign from malignant neurogenic tumors of nerve sheath origin. We performed a retrospective review of the medical record to select patients with nerve sheath tumors who had underdone FDG PET imaging. Fifteen patients (7F: 8M) with benign or malignant nerve sheath tumors were included in this study. Of the 15 patients, 9 were diagnosed with the known neurofibromatosis type I. A total of 19 nerve sheath tumors were included from the 15 patients. All patients had undergone FDG PET to evaluate for malignant potential of the known lesions. Images of FDG PET were semi-quantitatively analyzed and a region of interest (ROI) was placed over the area of the maximum FDG uptake and an average standardized uptake value was taken for final analysis. There were 5 malignant peripheral nerve sheath tumors, 5 schwannomas, and 9 neurofibromas. The mean SUV was 2 (ranged from 1.6 to 3.3) for schwannomas, 1.3 (0.7 to 2.5) for neurofibromas, and 8.4 (4.6 to 12.2) for malignant peripheral nerve sheath tumors. Of 14 benign tumors, all except one schwannoma showed a SUV less than 3. When a cutoff SUV of 4 was used to differentiate the nerve sheath tumors, all tumors were correctly classified as benign or malignant, respectively. Among the 9 patients diagnosed with neurofibromatosis type I. 4 had malignant peripheral nerve sheath tumors and FDG PET accurately detected all the 4 lesions with malignant transformation. According to our results, FDG PET seems to have a great potential for accurately characterizing benign versus malignant nerve sheath tumors. It appears to be extremely useful for patients with neurofibromatosis to localize the lesion with malignant transformation.

  13. Dural neurogenic inflammation induced by neuropathic pain is specific to cranial region.

    Science.gov (United States)

    Filipović, B; Matak, I; Lacković, Z

    2014-05-01

    Up to now, dural neurogenic inflammation (DNI) has been studied primarily as a part of migraine pain pathophysiology. A recent study from our laboratory demonstrated the occurrence of DNI in response to peripheral trigeminal nerve injury. In this report, we characterize the occurrence of DNI after different peripheral nerve injuries in and outside of the trigeminal region. We have used the infraorbital nerve constriction injury model (IoNC) as a model of trigeminal neuropathic pain. Greater occipital nerve constriction injury (GoNC), partial transection of the sciatic nerve (ScNT) and sciatic nerve constriction injury (SCI) were employed to characterize the occurrence of DNI in response to nerve injury outside of the trigeminal region. DNI was measured as colorimetric absorbance of Evans blue plasma protein complexes. In addition, cellular inflammatory response in dural tissue was histologically examined in IoNC and SCI models. In comparison to the strong DNI evoked by IoNC, a smaller but significant DNI has been observed following the GoNC. However, DNI has not been observed either in cranial or in lumbar dura following ScNT and SCI. Histological evidence has demonstrated a dural proinflammatory cell infiltration in the IoNC model, which is in contrast to the SCI model. Inflammatory cell types (lymphocytes, plasma cells, and monocytes) have indicated the presence of sterile cellular inflammatory response in the IoNC model. To our knowledge, this is the first observation that the DNI evoked by peripheral neuropathic pain is specific to the trigeminal area and the adjacent occipital area. DNI after peripheral nerve injury consists of both plasma protein extravasation and proinflammatory cell infiltration.

  14. Minocycline treatment ameliorates interferon-alpha-induced neurogenic defects and depression-like behaviors in mice

    Directory of Open Access Journals (Sweden)

    Lian-Shun eZheng

    2015-01-01

    Full Text Available Interferon-alpha (IFN-α is a proinflammatory cytokine that is widely used for the treatment of chronic viral hepatitis and malignancy, because of its immune-activating, antiviral, and antiproliferative properties. However, long-term IFN-α treatment frequently causes depression, which limits its clinical utility. The precise molecular and cellular mechanisms of IFN-α-induced depression are not currently understood. Neural stem cells (NSCs in the hippocampus continuously generate new neurons, and some evidence suggests that decreased neurogenesis plays a role in the neuropathology of depression. We previously reported that IFN-α treatment suppressed hippocampal neurogenesis and induced depression-like behaviors via its receptors in the brain in adult mice. However, it is unclear how systemic IFN-α administration induces IFN-α signaling in the hippocampus. In this study, we analyzed the role of microglia, immune cells in the brain, in mediating the IFN-α-induced neurogenic defects and depressive behaviors. In vitro studies demonstrated that IFN-α treatment induced the secretion of endogenous IFN-α from microglia, which suppressed NSC proliferation. In vivo treatment of adult mice with IFN-α for five weeks increased the production of proinflammatory cytokines, including IFN-α, and reduced neurogenesis in the hippocampus. Both effects were prevented by simultaneous treatment with minocycline, an inhibitor of microglial activation. Furthermore, minocycline treatment significantly suppressed IFN-α-induced depressive behaviors in mice. These results suggest that microglial activation plays a critical role in the development of IFN-α-induced depression, and that minocycline is a promising drug for the treatment of IFN-α-induced depression in patients, especially those who are low responders to conventional antidepressant treatments.

  15. Stem cells expanded from the human embryonic hindbrain stably retain regional specification and high neurogenic potency.

    Science.gov (United States)

    Tailor, Jignesh; Kittappa, Raja; Leto, Ketty; Gates, Monte; Borel, Melodie; Paulsen, Ole; Spitzer, Sonia; Karadottir, Ragnhildur Thora; Rossi, Ferdinando; Falk, Anna; Smith, Austin

    2013-07-24

    Stem cell lines that faithfully maintain the regional identity and developmental potency of progenitors in the human brain would create new opportunities in developmental neurobiology and provide a resource for generating specialized human neurons. However, to date, neural progenitor cultures derived from the human brain have either been short-lived or exhibit restricted, predominantly glial, differentiation capacity. Pluripotent stem cells are an alternative source, but to ascertain definitively the identity and fidelity of cell types generated solely in vitro is problematic. Here, we show that hindbrain neuroepithelial stem (hbNES) cells can be derived and massively expanded from early human embryos (week 5-7, Carnegie stage 15-17). These cell lines are propagated in adherent culture in the presence of EGF and FGF2 and retain progenitor characteristics, including SOX1 expression, formation of rosette-like structures, and high neurogenic capacity. They generate GABAergic, glutamatergic and, at lower frequency, serotonergic neurons. Importantly, hbNES cells stably maintain hindbrain specification and generate upper rhombic lip derivatives on exposure to bone morphogenetic protein (BMP). When grafted into neonatal rat brain, they show potential for integration into cerebellar development and produce cerebellar granule-like cells, albeit at low frequency. hbNES cells offer a new system to study human cerebellar specification and development and to model diseases of the hindbrain. They also provide a benchmark for the production of similar long-term neuroepithelial-like stem cells (lt-NES) from pluripotent cell lines. To our knowledge, hbNES cells are the first demonstration of highly expandable neuroepithelial stem cells derived from the human embryo without genetic immortalization.

  16. Sciatic nerve compression by neurogenic heterotopic ossification: use of CT to determine surgical indications

    Energy Technology Data Exchange (ETDEWEB)

    Salga, Marjorie [Hopital Raymond Poincare, APHP, CIC-IT 805, Department of Physical Medicine and Rehabilitation, Garches (France); Jourdan, Claire [Hopital Raymond Poincare, APHP, CIC-IT 805, Department of Physical Medicine and Rehabilitation, Garches (France); Universite de Versailles Saint Quentin en Yvelines, Handi-Resp, (EA4047), Versailles (France); Durand, Marie-Christine [Hopital Raymond Poincare, APHP, CIC-IT 805, Department of Neurophysiology, Garches (France); Universite de Versailles Saint Quentin en Yvelines, Groupement de Recherche Clinique et Technologique sur le Handicap (GRCTH, EA 4497), Versailles (France); Hangard, Chloe; Carlier, Robert-Yves [Hopital Raymond Poincare, APHP, CIC-IT 805, Department of Medical Imaging, Garches (France); Denormandie, Philippe [Universite de Versailles Saint Quentin en Yvelines, Groupement de Recherche Clinique et Technologique sur le Handicap (GRCTH, EA 4497), Versailles (France); Hopital Raymond Poincare, APHP, CIC-IT 805, Department of Orthopaedic Surgery, Garches (France); Genet, Francois [Hopital Raymond Poincare, APHP, CIC-IT 805, Department of Physical Medicine and Rehabilitation, Garches (France); Universite de Versailles Saint Quentin en Yvelines, Groupement de Recherche Clinique et Technologique sur le Handicap (GRCTH, EA 4497), Versailles (France); Military Medical Service, Hopital d' Instruction des Armees Percy, Department of Physical Medicine and Rehabilitation, Clamart (France)

    2014-09-14

    To describe the characteristics of neurogenic heterotopic ossification (NHO) based on clinical tests, electroneuromyography (ENMG) and CT in a database of patients with lesions of the central nervous system who required sciatic nerve neurolysis along with posterior hip NHO resection, and to determine the respective roles of ENMG and CT in the management of posterior hip NHOs in patients who are unable to communicate or express pain. The consistency of the ENMG results with clinical findings, CT results and macroscopic signs of lesions was retrospectively assessed after sciatic nerve neurolysis and ablation of 55 posterior hip NHOs. Sciatic nerve neurolysis was necessary in 55 cases (47.4 %; 55 out of 116). CT showed contact of the NHO with the nerve in all cases: 5 in contact with no deflection, 3 in contact with deflection, 21 moulded into a gutter and 26 entrapped in the NHO. There were clinical signs of sciatic nerve lesion in 21.8 % of cases (12 out of 55). ENMG showed signs of sciatic nerve lesions in only 55.6 % (10 out of 18), only 4 of whom presented with clinical signs of a nerve lesion. No significant relationship was found between clinical symptoms and ENMG findings of sciatic nerve compression (n = 13, p = 0.77). Nerve compression by NHO is likely an underdiagnosed condition, particularly in patients who are unable to communicate. Diagnosis of sciatic compression by NHO should be based on regular clinical examinations and CT. ENMG is not sufficiently sensitive to be used alone for surgical decision-making. (orig.)

  17. Staphylococcus saprophyticus native valve endocarditis in a diabetic patient with neurogenic bladder: A case report.

    Science.gov (United States)

    Magarifuchi, Hiroki; Kusaba, Koji; Yamakuchi, Hiroki; Hamada, Yohei; Urakami, Toshiharu; Aoki, Yosuke

    2015-09-01

    A 61-year-old man was admitted to our hospital with 2-day history of malaise and dyspnea. He had mitral prolapse and type II diabetes mellitus with neurogenic bladder, which was cared for by catheterization on his own. On arrival the patient was in septic condition with hypoxemia, and physical examination revealed systolic murmur at the apex. Transthoracic echocardiography revealed vegetation of the mitral and the aortic valve. The presence of continuous bacteremia was confirmed by multiple sets of blood culture, whereby gram-positive cocci was retrieved and identified as Staphylococcus saprophyticus (S. saprophyticus) both phenotypically and genetically. Because two major criteria of the Modified Duke Criteria were met, the patient was diagnosed with native valve endocarditis due to S. saprophyticus. The urine culture was also positive for gram-positive cocci, phenotypically identified as Staphylococcus warneri, which was subsequently identified as S. saprophyticus with the use of 16S rRNA gene sequence analysis and MALDI-TOF MS (matrix-assisted laser desorption ionization time of flight mass spectrometry), indicating strongly that the intermittent catheterization-associated urinary tract infection resulted in bacteremia that eventually lead to infective endocarditis. This patient was treated with vancomycin and clindamycin. Because of multiple cerebral infarctions, the patient underwent mitral and aortic valve replacement on hospital day 5. Blood culture turned negative at 6th hospital day. Antibiotic therapy was continued for six weeks after surgery. The patient's clinical course was uneventful thereafter, and was discharged home. This is the first case report of native valve endocarditis caused by S. saprophyticus of confirmed urinary origin.

  18. Staphylococcus saprophyticus native valve endocarditis in a diabetic patient with neurogenic bladder: A case report.

    Science.gov (United States)

    Magarifuchi, Hiroki; Kusaba, Koji; Yamakuchi, Hiroki; Hamada, Yohei; Urakami, Toshiharu; Aoki, Yosuke

    2015-09-01

    A 61-year-old man was admitted to our hospital with 2-day history of malaise and dyspnea. He had mitral prolapse and type II diabetes mellitus with neurogenic bladder, which was cared for by catheterization on his own. On arrival the patient was in septic condition with hypoxemia, and physical examination revealed systolic murmur at the apex. Transthoracic echocardiography revealed vegetation of the mitral and the aortic valve. The presence of continuous bacteremia was confirmed by multiple sets of blood culture, whereby gram-positive cocci was retrieved and identified as Staphylococcus saprophyticus (S. saprophyticus) both phenotypically and genetically. Because two major criteria of the Modified Duke Criteria were met, the patient was diagnosed with native valve endocarditis due to S. saprophyticus. The urine culture was also positive for gram-positive cocci, phenotypically identified as Staphylococcus warneri, which was subsequently identified as S. saprophyticus with the use of 16S rRNA gene sequence analysis and MALDI-TOF MS (matrix-assisted laser desorption ionization time of flight mass spectrometry), indicating strongly that the intermittent catheterization-associated urinary tract infection resulted in bacteremia that eventually lead to infective endocarditis. This patient was treated with vancomycin and clindamycin. Because of multiple cerebral infarctions, the patient underwent mitral and aortic valve replacement on hospital day 5. Blood culture turned negative at 6th hospital day. Antibiotic therapy was continued for six weeks after surgery. The patient's clinical course was uneventful thereafter, and was discharged home. This is the first case report of native valve endocarditis caused by S. saprophyticus of confirmed urinary origin. PMID:26184852

  19. Co-effects of matrix low elasticity and aligned topography on stem cell neurogenic differentiation and rapid neurite outgrowth

    Science.gov (United States)

    Yao, Shenglian; Liu, Xi; Yu, Shukui; Wang, Xiumei; Zhang, Shuming; Wu, Qiong; Sun, Xiaodan; Mao, Haiquan

    2016-05-01

    The development of novel biomaterials that deliver precise regulatory signals to direct stem cell fate for nerve regeneration is the focus of current intensive research efforts. In this study, a hierarchically aligned fibrillar fibrin hydrogel (AFG) that was fabricated through electrospinning and the concurrent molecular self-assembly process mimics both the soft and oriented features of nerve tissue, thus providing hybrid biophysical cues to instruct cell behavior in vitro and in vivo. The electrospun hydrogels were examined by scanning electron microscopy (SEM), polarized light microscopy, small angle X-ray scattering assay and atomic force microscopy (AFM), showing a hierarchically linear-ordered structure from the nanoscale to the macroscale with a soft elastic character (elasticity ~1 kPa). We found that this low elasticity and aligned topography of AFG exhibit co-effects on promoting the neurogenic differentiation of human umbilical cord mesenchymal stem cells (hUMSCs) in comparison to random fibrin hydrogel (RFG) and tissue culture plate (TCP) control after two week cell culture in growth medium lacking supplementation with soluble neurogenic induction factors. In addition, AFG also induces dorsal root ganglion (DRG) neurons to rapidly project numerous long neurite outgrowths longitudinally along the AFG fibers for a total neurite extension distance of 1.96 mm in three days in the absence of neurotrophic factor supplementation. Moreover, the AFG implanted in a rat T9 dorsal hemisection spinal cord injury model was found to promote endogenous neural cell fast migration and axonal invasion along AFG fibers, resulting in aligned tissue cables in vivo. Our results suggest that matrix stiffness and aligned topography may instruct stem cell neurogenic differentiation and rapid neurite outgrowth, providing great promise for biomaterial design for applications in nerve regeneration.The development of novel biomaterials that deliver precise regulatory signals to

  20. Programmed hyperphagia in offspring of obese dams: Altered expression of hypothalamic nutrient sensors, neurogenic factors and epigenetic modulators.

    Science.gov (United States)

    Desai, Mina; Han, Guang; Ross, Michael G

    2016-04-01

    Maternal overnutrition results in programmed offspring obesity, mediated in part, by hyperphagia. This is remarkably similar to the effects of maternal undernutrition on offspring hyperphagia and obesity. In view of the marked differences in the energy environment of the over and under-nutrition exposures, we studied the expression of select epigenetic modifiers associated with energy imbalance including neurogenic factors and appetite/satiety neuropeptides which are indicative of neurogenic differentiation. HF offspring were exposed to maternal overnutrition (high fat diet; HF) during pregnancy and lactation. We determined the protein expression of energy sensors (mTOR, pAMPK), epigenetic factors (DNA methylase, DNMT1; histone deacetylase, SIRT1/HDAC1), neurogenic factors (Hes1, Mash1, Ngn3) and appetite/satiety neuropeptides (AgRP/POMC) in newborn hypothalamus and adult arcuate nucleus (ARC). Despite maternal obesity, male offspring born to obese dams had similar body weight at birth as Controls. However, when nursed by the same dams, male offspring of obese dams exhibited marked adiposity. At 1 day of age, HF newborn males had significantly decreased energy sensors, DNMT1 including Hes1 and Mash1, which may impact neuroprogenitor cell proliferation and differentiation. This is consistent with increased AgRP in HF newborns. At 6 months of age, HF adult males had significantly increased energy sensors and decreased histone deactylases. In addition, the persistent decreased Hes1, Mash1 as well as Ngn3 are consistent with increased AgRP and decreased POMC. Thus, altered energy sensors and epigenetic responses which modulate gene expression and adult neuronal differentiation may contribute to hyperphagia and obesity in HF male offspring.

  1. Co-effects of matrix low elasticity and aligned topography on stem cell neurogenic differentiation and rapid neurite outgrowth.

    Science.gov (United States)

    Yao, Shenglian; Liu, Xi; Yu, Shukui; Wang, Xiumei; Zhang, Shuming; Wu, Qiong; Sun, Xiaodan; Mao, Haiquan

    2016-05-21

    The development of novel biomaterials that deliver precise regulatory signals to direct stem cell fate for nerve regeneration is the focus of current intensive research efforts. In this study, a hierarchically aligned fibrillar fibrin hydrogel (AFG) that was fabricated through electrospinning and the concurrent molecular self-assembly process mimics both the soft and oriented features of nerve tissue, thus providing hybrid biophysical cues to instruct cell behavior in vitro and in vivo. The electrospun hydrogels were examined by scanning electron microscopy (SEM), polarized light microscopy, small angle X-ray scattering assay and atomic force microscopy (AFM), showing a hierarchically linear-ordered structure from the nanoscale to the macroscale with a soft elastic character (elasticity ∼1 kPa). We found that this low elasticity and aligned topography of AFG exhibit co-effects on promoting the neurogenic differentiation of human umbilical cord mesenchymal stem cells (hUMSCs) in comparison to random fibrin hydrogel (RFG) and tissue culture plate (TCP) control after two week cell culture in growth medium lacking supplementation with soluble neurogenic induction factors. In addition, AFG also induces dorsal root ganglion (DRG) neurons to rapidly project numerous long neurite outgrowths longitudinally along the AFG fibers for a total neurite extension distance of 1.96 mm in three days in the absence of neurotrophic factor supplementation. Moreover, the AFG implanted in a rat T9 dorsal hemisection spinal cord injury model was found to promote endogenous neural cell fast migration and axonal invasion along AFG fibers, resulting in aligned tissue cables in vivo. Our results suggest that matrix stiffness and aligned topography may instruct stem cell neurogenic differentiation and rapid neurite outgrowth, providing great promise for biomaterial design for applications in nerve regeneration. PMID:27124547

  2. Hydrogen sulfide and neurogenic inflammation in polymicrobial sepsis: involvement of substance P and ERK-NF-κB signaling.

    Directory of Open Access Journals (Sweden)

    Seah-Fang Ang

    Full Text Available Hydrogen sulfide (H(2S has been shown to induce transient receptor potential vanilloid 1 (TRPV1-mediated neurogenic inflammation in polymicrobial sepsis. However, endogenous neural factors that modulate this event and the molecular mechanism by which this occurs remain unclear. Therefore, this study tested the hypothesis that whether substance P (SP is one important neural element that implicates in H(2S-induced neurogenic inflammation in sepsis in a TRPV1-dependent manner, and if so, whether H(2S regulates this response through activation of the extracellular signal-regulated kinase-nuclear factor-κB (ERK-NF-κB pathway. Male Swiss mice were subjected to cecal ligation and puncture (CLP-induced sepsis and treated with TRPV1 antagonist capsazepine 30 minutes before CLP. DL-propargylglycine (PAG, an inhibitor of H(2S formation, was administrated 1 hour before or 1 hour after sepsis, whereas sodium hydrosulfide (NaHS, an H(2S donor, was given at the same time as CLP. Capsazepine significantly attenuated H(2S-induced SP production, inflammatory cytokines, chemokines, and adhesion molecules levels, and protected against lung and liver dysfunction in sepsis. In the absence of H(2S, capsazepine caused no significant changes to the PAG-mediated attenuation of lung and plasma SP levels, sepsis-associated systemic inflammatory response and multiple organ dysfunction. In addition, capsazepine greatly inhibited phosphorylation of ERK(1/2 and inhibitory κBα, concurrent with suppression of NF-κB activation even in the presence of NaHS. Furthermore, capsazepine had no effect on PAG-mediated abrogation of these levels in sepsis. Taken together, the present findings show that H(2S regulates TRPV1-mediated neurogenic inflammation in polymicrobial sepsis through enhancement of SP production and activation of the ERK-NF-κB pathway.

  3. Neurogenic effect of VEGF is related to increase of astrocytes transdifferentiation into new mature neurons in rat brains after stroke.

    Science.gov (United States)

    Shen, Shu-Wen; Duan, Chun-Ling; Chen, Xian-Hua; Wang, Yong-Quan; Sun, Xiao; Zhang, Qiu-Wan; Cui, Hui-Ru; Sun, Feng-Yan

    2016-09-01

    To study the cellular mechanism of vascular endothelial growth factor (VEGF)-enhanced neurogenesis in ischemic brain injury, we used middle cerebral artery occlusion (MCAO) model to induce transient focal ischemic brain injury. The results showed that ischemic injury significantly increased glial fibrillary acidic protein immunopositive (GFAP(+)) and nestin(+) cells in ipsilateral striatum 3 days following MCAO. Most GFAP(+) cells colocalized with nestin (GFAP(+)-nestin(+)), Pax6 (GFAP(+)-Pax6(+)), or Olig2 (GFAP(+)-Olig2(+)). VEGF further increased GFAP(+)-nestin(+) and GFAP(+)-Pax6(+) cells, and decreased GFAP(+)-Olig2(+) cells. We used striatal injection of GFAP targeted enhanced green fluorescence protein (pGfa2-EGFP) vectors combined with multiple immunofluorescent staining to trace the neural fates of EGFP-expressing (GFP(+)) reactive astrocytes. The results showed that MCAO-induced striatal reactive astrocytes differentiated into neural stem cells (GFP(+)-nestin(+) cells) at 3 days after MCAO, immature (GFP(+)-Tuj-1(+) cells) at 1 week and mature neurons (GFP(+)-MAP-2(+) or GFP(+)-NeuN(+) cells) at 2 weeks. VEGF increased GFP(+)-NeuN(+) and BrdU(+)-MAP-2(+) newborn neurons after MCAO. Fluorocitrate, an astrocytic inhibitor, significantly decreased GFAP and nestin expression in ischemic brains, and also reduced VEGF-enhanced neurogenic effects. This study is the first time to report that VEGF-mediated increase of newly generated neurons is dependent on the presence of reactive astrocytes. The results also illustrate cellular mechanism of VEGF-enhanced neural repair and functional plasticity in the brains after ischemic injury. We concluded that neurogenic effect of VEGF is related to increase of striatal astrocytes transdifferentiation into new mature neurons, which should be very important for the reconstruction of neurovascular units/networks in non-neurogenic regions of the mammalian brain. PMID:26603138

  4. Programmed hyperphagia in offspring of obese dams: Altered expression of hypothalamic nutrient sensors, neurogenic factors and epigenetic modulators.

    Science.gov (United States)

    Desai, Mina; Han, Guang; Ross, Michael G

    2016-04-01

    Maternal overnutrition results in programmed offspring obesity, mediated in part, by hyperphagia. This is remarkably similar to the effects of maternal undernutrition on offspring hyperphagia and obesity. In view of the marked differences in the energy environment of the over and under-nutrition exposures, we studied the expression of select epigenetic modifiers associated with energy imbalance including neurogenic factors and appetite/satiety neuropeptides which are indicative of neurogenic differentiation. HF offspring were exposed to maternal overnutrition (high fat diet; HF) during pregnancy and lactation. We determined the protein expression of energy sensors (mTOR, pAMPK), epigenetic factors (DNA methylase, DNMT1; histone deacetylase, SIRT1/HDAC1), neurogenic factors (Hes1, Mash1, Ngn3) and appetite/satiety neuropeptides (AgRP/POMC) in newborn hypothalamus and adult arcuate nucleus (ARC). Despite maternal obesity, male offspring born to obese dams had similar body weight at birth as Controls. However, when nursed by the same dams, male offspring of obese dams exhibited marked adiposity. At 1 day of age, HF newborn males had significantly decreased energy sensors, DNMT1 including Hes1 and Mash1, which may impact neuroprogenitor cell proliferation and differentiation. This is consistent with increased AgRP in HF newborns. At 6 months of age, HF adult males had significantly increased energy sensors and decreased histone deactylases. In addition, the persistent decreased Hes1, Mash1 as well as Ngn3 are consistent with increased AgRP and decreased POMC. Thus, altered energy sensors and epigenetic responses which modulate gene expression and adult neuronal differentiation may contribute to hyperphagia and obesity in HF male offspring. PMID:26785315

  5. Exposure to N-Ethyl-N-Nitrosourea in Adult Mice Alters Structural and Functional Integrity of Neurogenic Sites

    Science.gov (United States)

    Capilla-Gonzalez, Vivian; Gil-Perotin, Sara; Ferragud, Antonio; Bonet-Ponce, Luis; Canales, Juan Jose; Garcia-Verdugo, Jose Manuel

    2012-01-01

    Background Previous studies have shown that prenatal exposure to the mutagen N-ethyl-N-nitrosourea (ENU), a N-nitroso compound (NOC) found in the environment, disrupts developmental neurogenesis and alters memory formation. Previously, we showed that postnatal ENU treatment induced lasting deficits in proliferation of neural progenitors in the subventricular zone (SVZ), the main neurogenic region in the adult mouse brain. The present study is aimed to examine, in mice exposed to ENU, both the structural features of adult neurogenic sites, incorporating the dentate gyrus (DG), and the behavioral performance in tasks sensitive to manipulations of adult neurogenesis. Methodology/Principal Findings 2-month old mice received 5 doses of ENU and were sacrificed 45 days after treatment. Then, an ultrastructural analysis of the SVZ and DG was performed to determine cellular composition in these regions, confirming a significant alteration. After bromodeoxyuridine injections, an S-phase exogenous marker, the immunohistochemical analysis revealed a deficit in proliferation and a decreased recruitment of newly generated cells in neurogenic areas of ENU-treated animals. Behavioral effects were also detected after ENU-exposure, observing impairment in odor discrimination task (habituation-dishabituation test) and a deficit in spatial memory (Barnes maze performance), two functions primarily related to the SVZ and the DG regions, respectively. Conclusions/Significance The results demonstrate that postnatal exposure to ENU produces severe disruption of adult neurogenesis in the SVZ and DG, as well as strong behavioral impairments. These findings highlight the potential risk of environmental NOC-exposure for the development of neural and behavioral deficits. PMID:22238669

  6. Metformin therapy to reduce weight gain and visceral adiposity in children and adolescents with neurogenic or myogenic motor deficit

    OpenAIRE

    Casteels, Kristina; Fieuws, Steffen; van Helvoirt, Maria; Verpoorten, Carla; Goemans, Nathalie; Coudyzer, Walter; Loeckx, Dirk; de Zegher, Francis

    2010-01-01

    The aim of this randomized, placebo-controlled study was to explore the effect of metformin in children with a neurogenic or myogenic motor deficit, who are therefore prone to develop overweight, adiposity, and insulin resistance. Study participants (n = 42) had a mean age of 15.5 yr, a short stature (height -2.4 SD), a relatively high BMI (+1.7 SD), and a high body fat fraction (41.9% or +2.8 SD). Abdominal CT confirmed the high fat mass and disclosed a high fraction of visceral fat. As expe...

  7. [Botulinum neurotoxin type A in neurogenic detrusor overactivity: consensus paper of the Working Group Neuro-Urology of the DMGP].

    Science.gov (United States)

    Böthig, R; Kaufmann, A; Bremer, J; Pannek, J; Domurath, B

    2014-04-01

    The use of botulinum neurotoxin (BoNT-A) for suppression of neurogenic detrusor overactivity was first reported in 2000. Since that time, this method has gained widespread use. A number of recommendations and consensus statements have already been published. The current practice-oriented consensus paper takes into account recent developments and the over 10-year experience of most members of the Working Group Neuro-Urology of the German-speaking Medical Society for Paraplegia (DMGP) with a focus on the use of BoNT-A in paraplegic patients and in patients with multiple sclerosis. PMID:24604016

  8. Stem cell recruitment of newly formed host cells via a successful seduction? Filling the gap between neurogenic niche and injured brain site.

    Directory of Open Access Journals (Sweden)

    Naoki Tajiri

    Full Text Available Here, we report that a unique mechanism of action exerted by stem cells in the repair of the traumatically injured brain involves their ability to harness a biobridge between neurogenic niche and injured brain site. This biobridge, visualized immunohistochemically and laser captured, corresponded to an area between the neurogenic subventricular zone and the injured cortex. That the biobridge expressed high levels of extracellular matrix metalloproteinases characterized initially by a stream of transplanted stem cells, but subsequently contained only few to non-detectable grafts and overgrown by newly formed host cells, implicates a novel property of stem cells. The transplanted stem cells manifest themselves as pathways for trafficking the migration of host neurogenic cells, but once this biobridge is formed between the neurogenic site and the injured brain site, the grafted cells disappear and relinquish their task to the host neurogenic cells. Our findings reveal that long-distance migration of host cells from the neurogenic niche to the injured brain site can be achieved through transplanted stem cells serving as biobridges for initiation of endogenous repair mechanisms. This is the first report of a stem cell-paved "biobridge". Indeed, to date the two major schools of discipline in stem cell repair mechanism primarily support the concept of "cell replacement" and bystander effects of "trophic factor secretion". The present novel observations of a stem cell seducing a host cell to engage in brain repair advances basic science concepts on stem cell biology and extracellular matrix, as well as provokes translational research on propagating this stem cell-paved biobridge beyond cell replacement and trophic factor secretion for the treatment of traumatic brain injury and other neurological disorders.

  9. Stem cell recruitment of newly formed host cells via a successful seduction? Filling the gap between neurogenic niche and injured brain site.

    Science.gov (United States)

    Tajiri, Naoki; Kaneko, Yuji; Shinozuka, Kazutaka; Ishikawa, Hiroto; Yankee, Ernest; McGrogan, Michael; Case, Casey; Borlongan, Cesar V

    2013-01-01

    Here, we report that a unique mechanism of action exerted by stem cells in the repair of the traumatically injured brain involves their ability to harness a biobridge between neurogenic niche and injured brain site. This biobridge, visualized immunohistochemically and laser captured, corresponded to an area between the neurogenic subventricular zone and the injured cortex. That the biobridge expressed high levels of extracellular matrix metalloproteinases characterized initially by a stream of transplanted stem cells, but subsequently contained only few to non-detectable grafts and overgrown by newly formed host cells, implicates a novel property of stem cells. The transplanted stem cells manifest themselves as pathways for trafficking the migration of host neurogenic cells, but once this biobridge is formed between the neurogenic site and the injured brain site, the grafted cells disappear and relinquish their task to the host neurogenic cells. Our findings reveal that long-distance migration of host cells from the neurogenic niche to the injured brain site can be achieved through transplanted stem cells serving as biobridges for initiation of endogenous repair mechanisms. This is the first report of a stem cell-paved "biobridge". Indeed, to date the two major schools of discipline in stem cell repair mechanism primarily support the concept of "cell replacement" and bystander effects of "trophic factor secretion". The present novel observations of a stem cell seducing a host cell to engage in brain repair advances basic science concepts on stem cell biology and extracellular matrix, as well as provokes translational research on propagating this stem cell-paved biobridge beyond cell replacement and trophic factor secretion for the treatment of traumatic brain injury and other neurological disorders.

  10. Long-term follow-up after botulinum toxin A (BTX-A) injection into the detrusor for treatment of neurogenic detrusor hyperactivity in children

    OpenAIRE

    Zeino, Mazen; Becker, Tanja; Koen, Mark; Berger, Christoph; Riccabona, Marcus

    2012-01-01

    Purpose To prove the long-term efficacy of BTX-A injection in the management of children with neurogenic detrusor hyperactivity. Materials and methods 28 out of 145 children with neurogenic bladder (15 male and 13 female, mean age 10.7 years) who were treated between 2002 and 2010 and became non-responders to conservative treatment were included into the retrospective study. We injected 10-12 U/kg of BTX-A (Botox®) into the detrusor at 20-30 sites, sparing the trigone. The mean follow-up was ...

  11. Pressure-flow study as an evaluating method of neurogenic urethral relaxation failure.

    Science.gov (United States)

    Sakakibara, R; Fowler, C J; Hattori, T; Hussain, I F; Swinn, M J; Uchiyama, T; Yamanishi, T

    2000-04-12

    Voiding difficulty is a common feature in neurological diseases, which can be attributed to dysfunction of the urethral sphincter and the detrusor. Electromyography (EMG)-cystometry can reveal the presence of detrusor-external sphincter dyssynergia (DESD), however, internal sphincter function on voiding is not easily evaluated. Pressure-flow study is widely used to diagnose benign outlet obstruction due to prostatic hypertrophy. We applied pressure-flow study in neurological patients in order to evaluate neurogenic urethral relaxation failure. We recruited 71 patients with neurological diseases. All were men under 60 years, with mean age of 44 years, ranging from 18 to 59 years. None had abnormal finding of digital examination or ultrasound echography of the prostate. Standard cystometry showed detrusor hyperreflexia in 33 patients and residual urine was noted in 36. DESD was noted in seven of 43 patients. Pressure-flow relation curve and a detrusor pressure (P(det)) at the point of maximum flow rate (Q(max)) (i.e., P(det)Q(max)) were obtained by urodynamic computers. The Abram-Griffiths (AG) number (P(det)Q(max)-2Q(max)), showing outlet obstruction particularly over 40, was also obtained. The points of P(det)Q(max) of the patients fell into three categories of the AG nomogram, showing obstruction in 19.7%, equivocal in 52.1% and unobstructed in 28.2%. Patients with DESD had AG number over 40 more commonly (57.1%) than those without DESD (8.4%) (p<0.05). The mean AG number was 46.4 in patients with DESD, which was larger than 17.1 in patients without DESD (p<0.01). Patients with detrusor hyperreflexia had AG number over 40 more commonly (42.4%) than those with normal cystometric curve (0%) (p<0.01). The mean AG number was 30.6 in patients with detrusor hyperreflexia, which was larger than 13.6 in patients with normal cystometric curve (p<0.01). The results showed that 19.7% of patients with neurological diseases had obstructive pattern (high pressure voiding

  12. A new treatment for neurogenic inflammation caused by EV71 with CR2-targeted complement inhibitor

    Directory of Open Access Journals (Sweden)

    Qiu Shaofu

    2012-11-01

    Full Text Available Abstract Background Enterovirus 71 (EV71, one of the most important neurotropic EVs, has caused death and long-term neurological sequelae in hundreds of thousands of young children in the Asia-Pacific region in the past decade. The neurological diseases are attributed to infection by EV71 inducing an extensive peripheral and central nervous system (CNS inflammatory response with abnormal cytokine production and lymphocyte depletion induced by EV71 infection. In the absence of specific antiviral agents or vaccines, an effective immunosuppressive strategy would be valuable to alleviate the severity of the local inflammation induced by EV71 infection. Presentation of the hypothesis The complement system plays a pivotal role in the inflammatory response. Inappropriate or excessive activation of the complement system results in a severe inflammatory reaction or numerous pathological injuries. Previous studies have revealed that EV71 infection can induce complement activation and an inflammatory response of the CNS. CR2-targeted complement inhibition has been proved to be a potential therapeutic strategy for many diseases, such as influenza virus-induced lung tissue injury, postischemic cerebral injury and spinal cord injury. In this paper, a mouse model is proposed to test whether a recombinant fusion protein consisting of CR2 and a region of Crry (CR2-Crry is able to specifically inhibit the local complement activation induced by EV71 infection, and to observe whether this treatment strategy can alleviate or even cure the neurogenic inflammation. Testing the hypothesis CR2-Crry is expressed in CHO cells, and its biological activity is determined by complement inhibition assays. 7-day-old ICR mice are inoculated intracranially with EV71 to duplicate the neurological symptoms. The mice are then divided into two groups, in one of which the mice are treated with CR2-Crry targeted complement inhibitor, and in the other with phosphate-buffered saline. A

  13. PET-Scan Shows Peripherally Increased Neurokinin 1 Receptor Availability in Chronic Tennis Elbow: Visualizing Neurogenic Inflammation?

    Science.gov (United States)

    Peterson, Magnus; Svärdsudd, Kurt; Appel, Lieuwe; Engler, Henry; Aarnio, Mikko; Gordh, Torsten; Långström, Bengt; Sörensen, Jens

    2013-01-01

    In response to pain, neurokinin 1 (NK1) receptor availability is altered in the central nervous system. The NK1 receptor and its primary agonist, substance P, also play a crucial role in peripheral tissue in response to pain, as part of neurogenic inflammation. However, little is known about alterations in NK1 receptor availability in peripheral tissue in chronic pain conditions and very few studies have been performed on human beings. Ten subjects with chronic tennis elbow were therefore examined by positron emission tomography (PET) with the NK1 specific radioligand [11C]GR205171 before and after treatment with graded exercise. The radioligand signal intensity was higher in the affected arm as compared with the unaffected arm, measured as differences between the arms in volume of voxels and signal intensity of this volume above a reference threshold set as 2.5 SD above mean signal intensity of the unaffected arm before treatment. In the eight subjects examined after treatment, pain ratings decreased in all subjects but signal intensity decreased in five and increased in three. In conclusion, NK1 receptors may be activated, or up-regulated in the peripheral, painful tissue of a chronic pain condition. This up-regulation does, however, have moderate correlation to pain ratings. The increased NK1 receptor availability is interpreted as part of ongoing neurogenic inflammation and may have correlation to the pathogenesis of chronic tennis elbow. Trial Registration ClinicalTrials.gov NCT00888225 http://clinicaltrials.gov/ PMID:24155873

  14. Neurogenic inflammation in the upper digestive tract of the mule duck: effect of a chemical algogen and force-feeding.

    Science.gov (United States)

    Servière, J; Carriere, M; Duvaux-Ponter, C; Guy, G; Roussel, S

    2011-12-01

    1.The objectives were to quantify the presence of neurogenic inflammation in 4 regions of the upper digestive tract of anaesthetised ducks (post-pharynx, pseudo-crop, transition between the pseudo-crop and the proventriculus, and proventriculus) after application of HCl stimulation of up to 4 M in the pseudo-crop. 2.The second objective was to quantify the presence of neurogenic inflammation in the same digestive tract regions as mentioned above during 4 feeding periods of foie gras production (rearing, preparation to force-feeding, and second and last meals of the force-feeding period). 3. Extravasation increased above a HCl stimulation threshold of 2 M. Furthermore, more extravasation was observed in the proventriculus compared to the other regions (P < 0·001). 4.Highest extravasation responses were observed in the proventriculus and the pseudo-crop at the end of the preparation period, and in the proventriculus after the second forced meal, compared with the rearing period (P < 0·01), with a return to rearing level at the end of force-feeding. 5.Such a kinetic could be indicative of a relative mildness of the irritant components associated with this feeding practice.

  15. Msxb is a core component of the genetic circuitry specifying the dorsal and ventral neurogenic midlines in the ascidian embryo.

    Science.gov (United States)

    Roure, Agnès; Darras, Sébastien

    2016-01-01

    The tail ascidian larval peripheral nervous system is made up of epidermal sensory neurons distributed more or less regularly in ventral and dorsal midlines. Their formation occurs in two-steps: the ventral and dorsal midlines are induced as neurogenic territories by Fgf9/16/20 and Admp respectively. The Delta2/Notch interaction then controls the number of neurons that form. The genetic machinery acting between the inductive processes taking place before gastrulation and neuron specification at tailbud stages are largely unknown. The analysis of seven transcription factors expressed in the forming midlines revealed an unexpected complexity and dynamic of gene expression. Their systematic overexpression confirmed that these genes do not interact following a linear cascade of activation. However, the integration of our data revealed the distinct key roles of the two upstream factors Msxb and Nkx-C that are the earliest expressed genes and the only ones able to induce neurogenic midline and ESN formation. Our data suggest that Msxb would be the primary midline gene integrating inputs from the ventral and dorsal inducers and launching a pan-midline transcriptional program. Nkx-C would be involved in tail tip specification, in maintenance of the pan-midline network and in a posterior to anterior wave controlling differentiation. PMID:26592100

  16. Neurogenic Niche Microglia Undergo Positional Remodeling and Progressive Activation Contributing to Age-Associated Reductions in Neurogenesis.

    Science.gov (United States)

    Solano Fonseca, Rene; Mahesula, Swetha; Apple, Deana M; Raghunathan, Rekha; Dugan, Allison; Cardona, Astrid; O'Connor, Jason; Kokovay, Erzsebet

    2016-04-01

    Neural stem cells (NSCs) exist throughout life in the ventricular-subventricular zone (V-SVZ) of the mammalian forebrain. During aging NSC function is diminished through an unclear mechanism. In this study, we establish microglia, the immune cells of the brain, as integral niche cells within the V-SVZ that undergo age-associated repositioning in the V-SVZ. Microglia become activated early before NSC deficits during aging resulting in an antineurogenic microenvironment due to increased inflammatory cytokine secretion. These age-associated changes were not observed in non-neurogenic brain regions, suggesting V-SVZ microglia are specialized. Using a sustained inflammatory model in young adult mice, we induced microglia activation and inflammation that was accompanied by reduced NSC proliferation in the V-SVZ. Furthermore, in vitro studies revealed secreted factors from activated microglia reduced proliferation and neuron production compared to secreted factors from resting microglia. Our results suggest that age-associated chronic inflammation contributes to declines in NSC function within the aging neurogenic niche. PMID:26857912

  17. Systemic application of rhenium-186 hydroxyethylidenediphosphonate ({sup 186}Re HEDP) as an option for the treatment of chronic arthritis and arthropathy[Radiosynoviorthesis]; Systemische Applikation von Rhenium-186 Hydroxyethylidendiphosphonat ({sup 186}Re HEDP) als Therapieoption bei chronischen Arthritiden und Arthropathien

    Energy Technology Data Exchange (ETDEWEB)

    Bucerius, J.; Biersack, H.J.; Palmedo, H. [Klinik und Poliklinik fuer Nuklearmedizin, Universitaetsklinikum Bonn (Germany); Wallny, T. [Orthopaedische Klinik l, Klinik fuer Orthopaedische Chirurgie, St. Bernhard-Hospital Kamp-Lintfort (Germany); Klinik und Poliklinik fuer Orthopaedie, Universitaetsklinikum Bonn (Germany); Brackmann, H.H. [Inst. fuer experimentelle Haematologie und Transfusionsmedizin, Universitaetsklinikum Bonn (Germany)

    2006-03-15

    Chronic arthritis is very common and is associated with a variety of systemic diseases whereas hemophilic arthropathy is one of the most common clinical manifestations of hemophilia, mainly of hemophilia type A. All of these polyarticular diseases are associated with progressive pain and increasing lack of mobility. Therapy is based on conservative treatment such as medication with non-steroidal anti-inflammatory drugs, selective therapy strategies such as intraarticular injections of e.g. radioactive substances (radiosynoviorthesis) or surgical interventions. However, in some cases, the disease does not respond to one of these treatment options or cannot be continued due to important side-effects. Systemic application of radioisotopes like {sup 186}Re HEDP has been successfully administered for pain palliation of osseous metastases. Today, only few data exist for systemic therapy with {sup 186}Re HEDP in patients suffering from benign polyarticular disease. In a prospective study with patients suffering from chronic arthritis a single systemic application of {sup 186}Re HEDP led to a reduction of disease activity in six of eight and to a reduction of the number of painful or swollen joints in five of eight included patients. In a further prospective study with 12 patients with hemophilic arthropathy, 19 of 36 (52.7%) most painful joints could be successfully treated with one systemic {sup 186}Re HEDP therapy. Furthermore, a reduction of global pain could be observed in those patients. However, further randomized studies with larger study populations are necessary in order to confirm this promising results. (orig.)

  18. Al-Aqeel Sewairi Syndrome, a new autosomal recessive disorder with multicentric osteolysis, nodulosis and arthropathy. The first genetic defect of matrix metalloproteinase 2 gene

    International Nuclear Information System (INIS)

    We report a distinctive autosomal recessive multicentric osteolysis in Saudi Arabian families with distal arthropathy of the metacarpal, metatarsal and interphalangeal joints, with ultimate progression to the proximal joints with decreased range of movements and deformities with ankylosis and generalized osteopenia. In addition, they had large, painful to touch palmar and plantar pads. Hirsutism and mild dysmorphic facial features including proptosis, a narrow nasal bridge, bulbous nose and micrognathia. Using a genome-wide search for microsatellite markers from 11 members of the family from the Armed Forces Hospital and King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia, localized the disease gene to chromosome 16q12-21. Haplotype analysis with additional markers narrowed the critical region to 1.2cM and identified the matrix metalloproteinase 2 (MMP-2), (gelatinase A, collagenase type IV, EC 3.4, 24,24) gene as a disease candidate at Mount Sinai School of Medicine, New York, United States of America in April 2000. Some affected individuals were homoallelic for a nonsense mutation (TCA>TAA) in codon 244 of exon 5, predicting the replacement of a tyrosine residue by a stop codon in the first fibronectin type II domain (Y244X). Other affected members had a missense mutation in exon 2 arginine 101-histidine (R101H) leading to no MMP-2 enzyme activity in serum or fibroblast or both of affected individuals. In other affected members, a non-pathogenic homoallelic GT transversion resulted in the substitution of an aspartate with a tyrosine residue in codon 210 of exon 4 (D210Y). The MMP-2-null mouse has no developmental defects, but are small, which may reflect genetic redundancy. The discovery that deficiency of this well-characterized gelatinase/collagenase results in an inherited form of an osteolytic and arthritic disorder provides an invaluable insights for the understanding of osteolysis and arthritis and is the first genetic

  19. Simplified scoring of the Actionable 8-item screening questionnaire for neurogenic bladder overactivity in multiple sclerosis: a comparative analysis of test performance at different cut-off points

    NARCIS (Netherlands)

    Jongen, P.J.; Blok, B.F.; Heesakkers, J.P.F.A.; Heerings, M.; Lemmens, W.A.J.G.; Donders, R.

    2015-01-01

    BACKGROUND: The Actionable questionnaire is an 8-item tool to screen patients with multiple sclerosis (MS) for neurogenic bladder problems, identifying those patients who might benefit from urological referral and bladder-specific treatment. The original scoring yields a total score of 0 to 24 with

  20. Simplified scoring of the Actionable 8-item screening questionnaire for neurogenic bladder overactivity in multiple sclerosis : a comparative analysis of test performance at different cut-off points

    NARCIS (Netherlands)

    Jongen, Peter Joseph; Blok, Bertil F.; Heesakkers, John P.; Heerings, Marco; Lemmens, Wim A.; Donders, Rogier

    2015-01-01

    Background: The Actionable questionnaire is an 8-item tool to screen patients with multiple sclerosis (MS) for neurogenic bladder problems, identifying those patients who might benefit from urological referral and bladder-specific treatment. The original scoring yields a total score of 0 to 24 with

  1. Human dental pulp stem cells with highly angiogenic and neurogenic potential for possible use in pulp regeneration.

    Science.gov (United States)

    Nakashima, Misako; Iohara, Koichiro; Sugiyama, Masahiko

    2009-01-01

    Dental caries is a common public health problem, causing early loss of dental pulp and resultant tooth loss. Dental pulp has important functions to sustain teeth providing nutrient and oxygen supply, innervation, reactionary/reparative dentin formation and immune response. Regeneration of pulp is an unmet need in endodontic therapy, and angiogenesis/vasculogenesis and neurogenesis are critical for pulp regeneration. Permanent and deciduous pulp tissue is easily available from teeth after extraction without ethical issues and has potential for clinical use. In this review, we introduce some stem cell subfractions, CD31(-)/CD146(-) SP cells and CD105(+) cells with high angiogenic and neurogenic potential, derived from human adult dental pulp tissue. Potential utility of these cells is addressed as a source of cells for treatment of cerebral and limb ischemia and pulp inflammation complete with angiogenesis and vasculogenesis.

  2. Transient Receptor Potential Ankyrin 1 Channel Localized to Non-Neuronal Airway Cells Promotes Non-Neurogenic Inflammation

    DEFF Research Database (Denmark)

    Nassini, Romina; Pedretti, Pamela; Moretto, Nadia;

    2012-01-01

    inflammation in asthma or chronic obstructive pulmonary disease raises an alternative possibility that airway inflammation is promoted by non-neuronal TRPA1.By using Real-Time PCR and calcium imaging, we found that cultured human airway cells, including fibroblasts, epithelial and smooth muscle cells express...... functional TRPA1 channels. By using immunohistochemistry, TRPA1 staining was observed in airway epithelial and smooth muscle cells in sections taken from human airways and lung, and from airways and lung of wild-type, but not TRPA1-deficient mice. In cultured human airway epithelial and smooth muscle cells...... (BAL) fluid of wild-type mice. This effect of TRPA1 agonists was attenuated by TRPA1 antagonism or in TRPA1-deficient mice, but not by pharmacological ablation of sensory nerves.Our results demonstrate that, although either TRPV1 or TRPA1 activation causes airway neurogenic inflammation, solely TRPA1...

  3. Transient receptor potential ankyrin 1 channel localized to non-neuronal airway cells promotes non-neurogenic inflammation

    DEFF Research Database (Denmark)

    Nassini, Romina; Pedretti, Pamela; Moretto, Nadia;

    2012-01-01

    inflammation in asthma or chronic obstructive pulmonary disease raises an alternative possibility that airway inflammation is promoted by non-neuronal TRPA1.By using Real-Time PCR and calcium imaging, we found that cultured human airway cells, including fibroblasts, epithelial and smooth muscle cells express...... activation orchestrates an additional inflammatory response which is not neurogenic. This finding suggests that non-neuronal TRPA1 in the airways is functional and potentially capable of contributing to inflammatory airway diseases....... functional TRPA1 channels. By using immunohistochemistry, TRPA1 staining was observed in airway epithelial and smooth muscle cells in sections taken from human airways and lung, and from airways and lung of wild-type, but not TRPA1-deficient mice. In cultured human airway epithelial and smooth muscle cells...

  4. Nitric oxide synthase inhibitors can antagonize neurogenic and calcitonin gene-related peptide induced dilation of dural meningeal vessels

    Science.gov (United States)

    Akerman, S; Williamson, D J; Kaube, H; Goadsby, P J

    2002-01-01

    The detailed pathophysiology of migraine is beginning to be understood and is likely to involve activation of trigeminovascular afferents. Clinically effective anti-migraine compounds are believed to have actions that include peripheral inhibition of calcitonin gene-related peptide (CGRP) release from trigeminal neurones, or preventing dural vessel dilation, or both. CGRP antagonists can block both neurogenic and CGRP-induced dural vessel dilation. Nitric oxide (NO) can induce headache in migraine patients and often triggers a delayed migraine. The initial headache is thought to be caused via a direct action of the NO–cGMP pathway that causes vasodilation by vascular smooth muscle relaxation, while the delayed headache is likely to be a result of triggering trigeminovascular activation. Nitric oxide synthase (NOS) inhibitors are effective in the treatment of acute migraine. The present studies used intravital microscopy to examine the effects of specific NOS inhibitors on neurogenic dural vasodilation (NDV) and CGRP-induced dilation. The non-specific and neuronal NOS (nNOS) inhibitors were able to partially inhibit NDV, while the non-specific and endothelial NOS (eNOS) inhibitors were able to partially inhibit the CGRP induced dilation. There was no effect of the inducible NOS (iNOS) inhibitor. The data suggest that the delayed headache response triggered by NO donors in humans may be due, in part, to increased nNOS activity in the trigeminal system that causes CGRP release and dural vessel dilation. Further, eNOS activity in the endothelium causes NO production and smooth muscle relaxation by direct activation of the NO–cGMP pathway, and may be involved in the initial headache response. PMID:12183331

  5. Artropatia de charcot do mediopé no paciente diabético: complicação de uma doença epidêmica Mid-foot charcot arthropathy in diabetic patients: complication of an epidemic disease

    Directory of Open Access Journals (Sweden)

    Ricardo Cardenuto Ferreira

    2012-10-01

    Full Text Available OBJETIVOS: Traçar o perfil epidemiológico dos pacientes diabéticos portadores de artropatia de Charcot acometendo exclusivamente o mediopé ou estendendo-se do mediopé ao retropé. Avaliar, a médio prazo, o resultado do tratamento a que esses pacientes são submetidos seguindo um protocolo preestabelecido. MÉTODOS: Avaliamos, retrospectivamente, 88 pacientes (110 extremidades portadores de artropatia de Charcot do mediopé, com seguimento mínimo de 12 meses. Incluímos os pacientes portadores de artropatia de Charcot acometendo as articulações tarsometatársicas, 45 pacientes (51%; as articulações talonavicular, calcaneocuboide e subtalar, 20 pacientes (23%; e aqueles com envolvimento do mediopé e retropé, 23 pacientes (26%, segundo Brodsky e Trepman. Definimos como sucesso a preservação de um pé funcional e insucesso como amputação do pé. RESULTADOS: O tratamento da artropatia de Charcot envolvendo primariamente o mediopé foram satisfatórios em 75 pacientes (85% tratados seguindo nosso protocolo. Nos pacientes com lesões graves, acometendo tanto o mediopé quanto o retropé, foi necessário maior número de cirurgias complexas do tipo artrodese para se obter o mesmo índice global de resultados satisfatórios. A lesão osteoarticular originada no mediopé provavelmente estende-se progressivamente ao retropé devido à demora no diagnóstico no início do tratamento adequado. CONCLUSÃO: Foi possível preservar uma extremidade funcional em 85% dos pacientes. Lesões graves envolvendo o mediopé e estendendo-se ao retropé necessitaram maior número de cirurgias para o tratamento.OBJECTIVES: To outline the epidemiological profile of diabetic patients with Charcot arthropathy affecting the midfoot alone or extending from the midfoot to the hindfoot; To assess the results from the treatment that these patients undergo, according to a preestablished protocol, over the medium term. METHODS: We retrospectively evaluated 88

  6. Neurogenic abnormalities in Alzheimer's disease differ between stages of neurogenesis and are partly related to cholinergic pathology.

    Science.gov (United States)

    Perry, Elaine K; Johnson, Mary; Ekonomou, Antigoni; Perry, Robert H; Ballard, Clive; Attems, Johannes

    2012-08-01

    Neurogenesis occurs in the subventricular zone and the sub-granular layer of the hippocampus and is thought to take place in 5 stages, including proliferation, differentiation, migration, targeting, and integration phases, respectively. In Alzheimer's disease (AD) both increased and decreased neurogenesis has been reported and cholinergic activity is assumed to be involved in neurogenesis. The aim of this study was to systematically assess different phases of neurogenesis and their relation to AD and cholinergic pathology. We investigated post-mortem brain tissue from 20 AD patients and 21 non-demented controls that was neuropathologically characterized according to standardized criteria. Hippocampal sections were stained with antibodies against neurogenic markers Musashi-1, nestin, PSA-NCAM, doublecortin, and β-III-tubulin as well as ChAT (choline-acetyltransferase). Using image analysis immunoreactivity was assessed in the subventricular zone, the sub-granular layer, and the granule cell layer by determining the integrated optical density. In the sub-granular layer and the granule cell layer Musashi-1 and ChAT immunoreactivities were significantly lower in AD and decreased with increasing Braak stages. Conversely, immunorreactivities of both nestin and PSA-NCAM were significantly higher in AD and increased with increasing Braak stages while no changes were seen for doublecortin and β-III-tubulin, except for significantly higher doublecortin levels in the granule cell layer of AD cases. Of note, Musashi-1 immunoreactivity significantly correlated with ChAT immuonoreactivity across different Braak stages. In the subventricular zone only nestin immunoreactivity was significantly higher in AD and significantly increased with increasing Braak stages, while no significant differences were seen for all other markers. Our finding of a reduction of ChAT and Musashi-1 levels in AD is compatible with the assumption that cholinergic pathology per se has a detrimental

  7. Onabotulinumtoxin A for Treating Overactive/Poor Compliant Bladders in Children and Adolescents with Neurogenic Bladder Secondary to Myelomeningocele

    Directory of Open Access Journals (Sweden)

    Antonio Marte

    2012-12-01

    Full Text Available This retrospective study was performed to verify the efficacy and safety of Onabotulinumtoxin A (BTX-A in treating children with neurogenic bladder (NB secondary to myelomeningocele (MMC with detrusor overactivity/low compliance. From January 2002 to June 2011, 47 patients out of 68 with neuropathic bladder were selected (22 females, 25 males, age range 5–17 years; mean age 10.7 years at first injection. They presented overactive/poor compliant neurogenic bladders on clean intermittent catheterization, and were resistant or non compliant to pharmacological therapy. Ten patients presented second to fourth grade concomitant monolateral/bilateral vesicoureteral reflux (VUR. All patients were incontinent despite catheterization. In the majority of patients Botulinum-A toxin was administered under general/local anesthesia by the injection of 200 IU of toxin, without exceeding the dosage of 12IU/kg body weight, diluted in 20 cc of saline solution in 20 sites, except in the periureteral areas. Follow-up included clinical and ultrasound examination, urodynamics performed at 6, 12 and 24 weeks, and annually thereafter. Seven patients remained stable, 21 patients required a second injection after 6–9 months and 19 a third injection. VUR was corrected, when necessary, in the same session after the BT-A injection, by 1–3 cc of subureteral Deflux®. Urodynamic parameters considered were leak point pressure (LPP, leak point volume (LPV and specific volume at 20 cm H2O pressure. The results were analyzed using the Wilcoxon test. All patients experienced a significant 66.45% average increase of LPV (Wilcoxon paired rank test = 7169 × 10 −10 and a significant 118.57% average increase of SC 20 (Wilcoxon paired rank test = 2.466 × 10 −12. The difference between preoperative and postoperative LPP resulted not significant (Wilcoxon paired rank test = 0.8858 No patient presented severe systemic complications; 38/47 patients presented slight hematuria for

  8. CD133 is not present on neurogenic astrocytes in the adult subventricular zone, but on embryonic neural stem cells, ependymal cells, and glioblastoma cells.

    Science.gov (United States)

    Pfenninger, Cosima V; Roschupkina, Teona; Hertwig, Falk; Kottwitz, Denise; Englund, Elisabet; Bengzon, Johan; Jacobsen, Sten Eirik; Nuber, Ulrike A

    2007-06-15

    Human brain tumor stem cells have been enriched using antibodies against the surface protein CD133. An antibody recognizing CD133 also served to isolate normal neural stem cells from fetal human brain, suggesting a possible lineage relationship between normal neural and brain tumor stem cells. Whether CD133-positive brain tumor stem cells can be derived from CD133-positive neural stem or progenitor cells still requires direct experimental evidence, and an important step toward such investigations is the identification and characterization of normal CD133-presenting cells in neurogenic regions of the embryonic and adult brain. Here, we present evidence that CD133 is a marker for embryonic neural stem cells, an intermediate radial glial/ependymal cell type in the early postnatal stage, and for ependymal cells in the adult brain, but not for neurogenic astrocytes in the adult subventricular zone. Our findings suggest two principal possibilities for the origin of brain tumor stem cells: a derivation from CD133-expressing cells, which are normally not present in the adult brain (embryonic neural stem cells and an early postnatal intermediate radial glial/ependymal cell type), or from CD133-positive ependymal cells in the adult brain, which are, however, generally regarded as postmitotic. Alternatively, brain tumor stem cells could be derived from proliferative but CD133-negative neurogenic astrocytes in the adult brain. In the latter case, brain tumor development would involve the production of CD133. PMID:17575139

  9. The Effect of Pro-Neurogenic Gene Expression on Adult Subventricular Zone Precursor Cell Recruitment and Fate Determination After Excitotoxic Brain Injury

    Science.gov (United States)

    Jones, Kathryn S; Connor, Bronwen J

    2016-01-01

    Despite the presence of on-going neurogenesis in the adult mammalian brain, neurons are generally not replaced after injury. Using a rodent model of excitotoxic cell loss and retroviral (RV) lineage tracing, we previously demonstrated transient recruitment of precursor cells from the subventricular zone (SVZ) into the lesioned striatum. In the current study we determined that these cells included migratory neuroblasts and oligodendrocyte precursor cells (OPC), with the predominant response from glial cells. We attempted to override this glial response by ectopic expression of the pro-neurogenic genes Pax6 or Dlx2 in the adult rat SVZ following quinolinic acid lesioning. RV-Dlx2 over-expression stimulated repair at a previously non-neurogenic time point by enhancing neuroblast recruitment and the percentage of cells that retained a neuronal fate within the lesioned area, compared to RV-GFP controls. RV-Pax6 expression was unsuccessful at inhibiting glial fate and intriguingly, increased OPC cell numbers with no change in neuronal recruitment. These findings suggest that gene choice is important when attempting to augment endogenous repair as the lesioned environment can overcome pro-neurogenic gene expression. Dlx2 over-expression however was able to partially overcome an anti-neuronal environment and therefore is a promising candidate for further study of striatal regeneration.

  10. Valproic acid, a histone deacetylase inhibitor, decreases proliferation of and induces specific neurogenic differentiation of canine adipose tissue-derived stem cells.

    Science.gov (United States)

    Kurihara, Yasuhiro; Suzuki, Takehito; Sakaue, Motoharu; Murayama, Ohoshi; Miyazaki, Yoko; Onuki, Atsushi; Aoki, Takuma; Saito, Miyoko; Fujii, Yoko; Hisasue, Masaharu; Tanaka, Kazuaki; Takizawa, Tatsuya

    2014-01-01

    Adipose tissue-derived stem cells (ADSCs) isolated from adult tissue have pluripotent differentiation and self-renewal capability. The tissue source of ADSCs can be obtained in large quantities and with low risks, thus highlighting the advantages of ADSCs in clinical applications. Valproic acid (VPA) is a widely used antiepileptic drug, which has recently been reported to affect ADSC differentiation in mice and rats; however, few studies have been performed on dogs. We aimed to examine the in vitro effect of VPA on canine ADSCs. Three days of pretreatment with VPA decreased the proliferation of ADSCs in a dose-dependent manner; VPA concentrations of 4 mM and above inhibited the proliferation of ADSCs. In parallel, VPA increased p16 and p21 mRNA expression, suggesting that VPA attenuated the proliferative activity of ADSCs by activating p16 and p21. Furthermore, the effects of VPA on adipogenic, osteogenic or neurogenic differentiation were investigated morphologically. VPA pretreatment markedly promoted neurogenic differentiation, but suppressed the accumulation of lipid droplets and calcium depositions. These modifications of ADSCs by VPA were associated with a particular gene expression profile, viz., an increase in neuronal markers, that is, NSE, TUBB3 and MAP2, a decrease in the adipogenic marker, LPL, but no changes in osteogenic markers, as estimated by reverse transcription-PCR analysis. These results suggested that VPA is a specific inducer of neurogenic differentiation of canine ADSCs and is a useful tool for studying the interaction between chromatin structure and cell fate determination.

  11. Effectiveness of manipulative physiotherapy for the treatment of a neurogenic cervicobrachial pain syndrome: a single case study -- experimental design.

    Science.gov (United States)

    Cowell, I M; Phillips, D R

    2002-02-01

    A single case study ABC design was used to evaluate the effectiveness of manipulative physiotherapy in a 44-year-old woman with an 8-month history of neurogenic cervicobrachial pain. Clinical examination demonstrated significant signs of upper quadrant neural tissue mechanosensitivity indicating that neural tissue was the dominant tissue of origin for the subject's complaint of pain. Magnetic resonance imaging revealed correlating discal pathology at the C5/6 intersegmental level. The study involved a 4-week pre-assessment phase, a 4-week treatment phase and a 2-week home exercise phase. Functional disability was measured using the Northwick Park Neck Pain Questionnaire and pain was assessed using the McGill Short Form Pain Questionnaire. Cervical motion was measured by a cervical range of motion device (CROM) and the range of shoulder abduction with a mediclino inclinometer. Manipulative physiotherapy treatment involved a cervical lateral glide mobilization technique. Following treatment, visual analysis revealed beneficial effects on pain, functional disability as well as cervical and shoulder mobility. These improvements were maintained over the home exercise phase and at 1-month follow-up. The single case limits generalization of the findings, but the results support previous studies in this area and gives further impetus to controlled clinical trials. PMID:11884154

  12. Neurogenic differentiation of human umbilical cord mesenchymal stem cells on aligned electrospun polypyrrole/polylactide composite nanofibers with electrical stimulation

    Science.gov (United States)

    Zhou, Junfeng; Cheng, Liang; Sun, Xiaodan; Wang, Xiumei; Jin, Shouhong; Li, Junxiang; Wu, Qiong

    2016-09-01

    Adult central nervous system (CNS) tissue has a limited capacity to recover after trauma or disease. Recent medical cell therapy using polymeric biomaterialloaded stem cells with the capability of differentiation to specific neural population has directed focuses toward the recovery of CNS. Fibers that can provide topographical, biochemical and electrical cues would be attractive for directing the differentiation of stem cells into electro-responsive cells such as neuronal cells. Here we report on the fabrication of an electrospun polypyrrole/polylactide composite nanofiber film that direct or determine the fate of mesenchymal stem cells (MSCs), via combination of aligned surface topography, and electrical stimulation (ES). The surface morphology, mechanical properties and electric properties of the film were characterized. Comparing with that on random surface film, expression of neurofilament-lowest and nestin of human umbilical cord mesenchymal stemcells (huMSCs) cultured on film with aligned surface topography and ES were obviously enhanced. These results suggest that aligned topography combining with ES facilitates the neurogenic differentiation of huMSCs and the aligned conductive film can act as a potential nerve scaffold.

  13. cis-Regulatory control of the initial neurogenic pattern of onecut gene expression in the sea urchin embryo.

    Science.gov (United States)

    Barsi, Julius C; Davidson, Eric H

    2016-01-01

    Specification of the ciliated band (CB) of echinoid embryos executes three spatial functions essential for postgastrular organization. These are establishment of a band about 5 cells wide which delimits and bounds other embryonic territories; definition of a neurogenic domain within this band; and generation within it of arrays of ciliary cells that bear the special long cilia from which the structure derives its name. In Strongylocentrotus purpuratus the spatial coordinates of the future ciliated band are initially and exactly determined by the disposition of a ring of cells that transcriptionally activate the onecut homeodomain regulatory gene, beginning in blastula stage, long before the appearance of the CB per se. Thus the cis-regulatory apparatus that governs onecut expression in the blastula directly reveals the genomic sequence code by which these aspects of the spatial organization of the embryo are initially determined. We screened the entire onecut locus and its flanking region for transcriptionally active cis-regulatory elements, and by means of BAC recombineered deletions identified three separated and required cis-regulatory modules that execute different functions. The operating logic of the crucial spatial control module accounting for the spectacularly precise and beautiful early onecut expression domain depends on spatial repression. Previously predicted oral ectoderm and aboral ectoderm repressors were identified by cis-regulatory mutation as the products of goosecoid and irxa genes respectively, while the pan-ectodermal activator SoxB1 supplies a transcriptional driver function.

  14. Differential regulation of cell proliferation in neurogenic zones in mice lacking cystine transport by xCT

    International Nuclear Information System (INIS)

    The cystine/glutamate exchanger (xCT) supplies intracellular cyst(e)ine for the production of glutathione, a major cellular anti-oxidant. xCT is enriched in brain regions associated with neurogenesis. Previous studies have shown that the malfunction of this protein greatly attenuates cell proliferation in vitro and is associated with brain atrophy in vivo. Using mice that are homozygous for a function-blocking deletion in xCT (Sut mice), we examined in vivo the role of xCT in cell proliferation in neurogenic regions of the subventricular zone (SVZ) and denate gyrus (DG) in the adult brain. Our results indicate that a high level of cellular proliferation in the adult brain persists even in the absence of functional xCT. Furthermore, in both young adult and middle-aged mice (3 and 11 months old), rates of SVZ cell proliferation were comparable between Sut and wild-type controls, although there was trend towards reduced proliferation in Sut mice (12% and 9% reduction, respectively). To our surprise, rates of cell proliferation in the DG were elevated in both 3- and 11-month-old Sut mice relative to controls (22% and 28% increase, respectively). These results demonstrate that xCT expression plays a role in regulating cellular proliferation in the DG, but not the SVZ of adult mice. Furthermore, unlike previous in vitro studies, our in vivo observations clearly indicate that xCT is not essential for ongoing cellular proliferation

  15. The role of brain-derived neurotrophic factor (BDNF) in the development of neurogenic detrusor overactivity (NDO).

    Science.gov (United States)

    Frias, Bárbara; Santos, João; Morgado, Marlene; Sousa, Mónica Mendes; Gray, Susannah M Y; McCloskey, Karen D; Allen, Shelley; Cruz, Francisco; Cruz, Célia Duarte

    2015-02-01

    Neurogenic detrusor overactivity (NDO) is a well known consequence of spinal cord injury (SCI), recognizable after spinal shock, during which the bladder is areflexic. NDO emergence and maintenance depend on profound plastic changes of the spinal neuronal pathways regulating bladder function. It is well known that neurotrophins (NTs) are major regulators of such changes. NGF is the best-studied NT in the bladder and its role in NDO has already been established. Another very abundant neurotrophin is BDNF. Despite being shown that, acting at the spinal cord level, BDNF is a key mediator of bladder dysfunction and pain during cystitis, it is presently unclear if it is also important for NDO. This study aimed to clarify this issue. Results obtained pinpoint BDNF as an important regulator of NDO appearance and maintenance. Spinal BDNF expression increased in a time-dependent manner together with NDO emergence. In chronic SCI rats, BDNF sequestration improved bladder function, indicating that, at later stages, BDNF contributes NDO maintenance. During spinal shock, BDNF sequestration resulted in early development of bladder hyperactivity, accompanied by increased axonal growth of calcitonin gene-related peptide-labeled fibers in the dorsal horn. Chronic BDNF administration inhibited the emergence of NDO, together with reduction of axonal growth, suggesting that BDNF may have a crucial role in bladder function after SCI via inhibition of neuronal sprouting. These findings highlight the role of BDNF in NDO and may provide a significant contribution to create more efficient therapies to manage SCI patients. PMID:25653370

  16. Micropatterning Extracellular Matrix Proteins on Electrospun Fibrous Substrate Promote Human Mesenchymal Stem Cell Differentiation Toward Neurogenic Lineage.

    Science.gov (United States)

    Li, Huaqiong; Wen, Feng; Chen, Huizhi; Pal, Mintu; Lai, Yuekun; Zhao, Allan Zijian; Tan, Lay Poh

    2016-01-13

    In this study, hybrid micropatterned grafts constructed via a combination of microcontact printing and electrospinning techniques process were utilized to investigate the influencing of patterning directions on human mesenchymal stem cells (hMSCs) differentiation to desired phenotypes. We found that the stem cells could align and elongate along the direction of the micropattern, where they randomly distributed on nonmicropatterned surfaces. Concomitant with patterning effect of component on stem cell alignment, a commensurate increase on the expression of neural lineage commitment markers, such as microtubule associated protein 2 (MAP2), Nestin, NeuroD1, and Class III β-Tubulin, were revealed from mRNA expression by quantitative Real Time PCR (qRT-PCR) and MAP2 expression by immunostaining. In addition, the effect of electrospun fiber orientation on cell behaviors was further examined. An angle of 45° between the direction of micropatterning and orientation of aligned fibers was verified to greatly prompt the outgrowth of filopodia and neurogenesis of hMSCs. This study demonstrates that the significance of hybrid components and electrospun fiber alignment in modulating cellular behavior and neurogenic lineage commitment of hMSCs, suggesting promising application of porous scaffolds with smart component and topography engineering in clinical regenerative medicine.

  17. Neurogenic differentiation of human umbilical cord mesenchymal stem cells on aligned electrospun polypyrrole/polylactide composite nanofibers with electrical stimulation

    Science.gov (United States)

    Zhou, Junfeng; Cheng, Liang; Sun, Xiaodan; Wang, Xiumei; Jin, Shouhong; Li, Junxiang; Wu, Qiong

    2016-07-01

    Adult central nervous system (CNS) tissue has a limited capacity to recover after trauma or disease. Recent medical cell therapy using polymeric biomaterialloaded stem cells with the capability of differentiation to specific neural population has directed focuses toward the recovery of CNS. Fibers that can provide topographical, biochemical and electrical cues would be attractive for directing the differentiation of stem cells into electro-responsive cells such as neuronal cells. Here we report on the fabrication of an electrospun polypyrrole/polylactide composite nanofiber film that direct or determine the fate of mesenchymal stem cells (MSCs), via combination of aligned surface topography, and electrical stimulation (ES). The surface morphology, mechanical properties and electric properties of the film were characterized. Comparing with that on random surface film, expression of neurofilament-lowest and nestin of human umbilical cord mesenchymal stemcells (huMSCs) cultured on film with aligned surface topography and ES were obviously enhanced. These results suggest that aligned topography combining with ES facilitates the neurogenic differentiation of huMSCs and the aligned conductive film can act as a potential nerve scaffold.

  18. The role of brain-derived neurotrophic factor (BDNF) in the development of neurogenic detrusor overactivity (NDO).

    Science.gov (United States)

    Frias, Bárbara; Santos, João; Morgado, Marlene; Sousa, Mónica Mendes; Gray, Susannah M Y; McCloskey, Karen D; Allen, Shelley; Cruz, Francisco; Cruz, Célia Duarte

    2015-02-01

    Neurogenic detrusor overactivity (NDO) is a well known consequence of spinal cord injury (SCI), recognizable after spinal shock, during which the bladder is areflexic. NDO emergence and maintenance depend on profound plastic changes of the spinal neuronal pathways regulating bladder function. It is well known that neurotrophins (NTs) are major regulators of such changes. NGF is the best-studied NT in the bladder and its role in NDO has already been established. Another very abundant neurotrophin is BDNF. Despite being shown that, acting at the spinal cord level, BDNF is a key mediator of bladder dysfunction and pain during cystitis, it is presently unclear if it is also important for NDO. This study aimed to clarify this issue. Results obtained pinpoint BDNF as an important regulator of NDO appearance and maintenance. Spinal BDNF expression increased in a time-dependent manner together with NDO emergence. In chronic SCI rats, BDNF sequestration improved bladder function, indicating that, at later stages, BDNF contributes NDO maintenance. During spinal shock, BDNF sequestration resulted in early development of bladder hyperactivity, accompanied by increased axonal growth of calcitonin gene-related peptide-labeled fibers in the dorsal horn. Chronic BDNF administration inhibited the emergence of NDO, together with reduction of axonal growth, suggesting that BDNF may have a crucial role in bladder function after SCI via inhibition of neuronal sprouting. These findings highlight the role of BDNF in NDO and may provide a significant contribution to create more efficient therapies to manage SCI patients.

  19. Resultados do tratamento cirúrgico da artropatia degenerativa do manguito rotador utilizando hemiartroplastia-CTA® Results of surgical treatment of denerative arthropathy of the rotator cuff using hemiarthroplasty-CTA®

    Directory of Open Access Journals (Sweden)

    Rômulo Brasil Filho

    2012-02-01

    Full Text Available OBJETIVO: Avaliar os resultados da artroplastia parcial de ombro tipo CTA® para o tratamento da artropatia degenerativa do manguito. MÉTODOS: De dezembro de 2006 a junho de 2009, 23 ombros de 23 pacientes foram submetidos à artroplastia parcial tipo CTA® para o tratamento de artropatia por lesão do manguito rotador. O tempo de seguimento pós-operatório variou de seis a 35 meses. A idade média foi de 74,1 anos. Houve predomínio do sexo feminino em 78,3% dos casos. O membro direito foi acometido em 18 pacientes. Todos os pacientes foram submetidos, sem melhora dos sintomas, ao tratamento fisioterápico prévio por pelo menos seis meses e foram submetidos à cirurgia pela mesma equipe cirúrgica. Nenhum dos pacientes havia realizado cirurgia prévia no ombro afetado. A avaliação dos pacientes no seguimento pós-operatório seguiu os critérios do escore da UCLA. RESULTADOS: Verificou-se melhora da dor em todos pacientes após a artroplastia. Pelo escore da UCLA, a média de pontos em relação à dor foi de 9,22 (variando de 10 a oito. Quanto à função, a média foi de seis (10 a dois. Encontramos nesses pacientes média de 2,39 na flexão frontal ativa (quatro a zero. Na força de flexão frontal a média foi de 4,09 com máxima de cinco e mínima de três. A média de pontos do escore da UCLA foi de 26,52. Noventa e cinco porcento dos pacientes ficaram satisfeitos com a cirurgia. CONCLUSÃO: A artroplastia parcial de ombro tipo CTA® tem resultados satisfatórios no tratamento da artropatia degenerativa do manguito rotador e apresenta baixa taxa de complicação.OBJECTIVE: To assess results of CTA® partial shoulder arthroplasty for treatment of degenerative arthropathy of the rotator cuff. METHODS: Between December 2006 and June 2009, 23 shoulders of 23 patients were submitted to CTA® type partial shoulder arthroplasty for treatment of arthropathy secondary to rotator cuff injury. Post-operative follow up time ranged from 6 to 35

  20. Immunomodulatory Effects of Th17/Treg Cells in Inflammatory Arthropathy%Th17/Treg细胞在炎性关节病的免疫调节作用

    Institute of Scientific and Technical Information of China (English)

    贾捷婷; 李慧; 李国青; 魏华; 张育

    2011-01-01

    There is a large class of rheumatic diseases which have main manifestation of peripheral arthritis. We could call them inflammatory arthropathy, including rheumatoid arthritis ( RA) , spondyloarthropathy ( SpA) and its related arthritis such as ankylosing spondylitis ( AS) , psoriatic arthritis ( PsA ) and inflammatory bowel disease associated arthritis and so on. Immune cells play an important role in their pathogenesis. In recent years, the T help cell 17 (Thl7) has been found, which mainly secretes IL-17 and mediates inflammatory response. The regulatory T cells (Treg) have immunosuppressive effects. Thl7 and Treg cells are closely related in their differentiation process and a variety of cytokines involved. The balance of Thl7/Treg cells are important in maintenance of normal immune response and preventing from autoimmune diseases. This paper does a review about the relationship between Thl7/Treg cells and the common inflammatory arthropathy.%炎性关节病包括一大类以外周关节炎为主要表现的风湿性疾病,如类风湿关节炎(rheumatoid arthritis,RA)、脊柱关节病(spondyloarthropathy,SpA)及其相关的关节炎,如强直性脊柱炎(ankylosing spondylitis,AS)、银屑病关节炎(psoriaticarthritis,PsA)和炎症性肠病关节炎等.免疫细胞在他们的发病过程中起了重要作用.近年又发现了一种以分泌IL-17为主的辅助性T细胞17(T help cell 17,Th17),其介导炎症反应.调节性T细胞(regulatoryT cells,Treg)是一类具有免疫抑制作用的T细胞哑群.Th17与Treg细胞在分化过程中是密切相关的,多种细胞因子参与了他们的发育分化过程,Th17/Treg细胞的平衡对维持正常免疫应答、防止自身免疫性疾病具有重要意义.

  1. Diminished neurogenic femoral artery vasoconstrictor response in a Zucker obese rat model: differential regulation of NOS and COX derivatives.

    Directory of Open Access Journals (Sweden)

    Ana Cristina Martínez

    Full Text Available OBJECTIVE: Peripheral arterial disease is one of the macrovascular complications of type 2 diabetes mellitus. This study addresses femoral artery regulation in a prediabetic model of obese Zucker rats (OZR by examining cross-talk between endothelial and neural factors. METHODS AND RESULTS: Arterial preparations from lean (LZR and OZR were subjected to electrical field stimulation (EFS on basal tone. Nitric oxide synthase (NOS and cyclooxygenase (COX isoform expression patterns were determined by immunohistochemical labelling and Western blotting. Results indicate significantly reduced noradrenergic contractions in preparations from OZR compared with those of LZR. Functional inhibition of endothelial NOS (eNOS indicated a predominant role of this isoform in LZR and its modified activity in OZR. Neural (nNOS and inducible NOS (iNOS were activated and their expression was higher in femoral arteries from OZR. Neurotransmission modulated by large-conductance Ca2+-activated (BKCa or voltage-dependent (KV K+ channels did not seem compromised in the obese animals. Endothelial COX-1 and COX-2 were expressed in LZR and an additional adventitial location of COX-2 was also observed in OZR, explaining the higher COX-2 protein levels detected in this group. Prostanoids derived from both isoforms helped maintain vasoconstriction in LZR while in OZR only COX-2 was active. Superoxide anion inhibition reduced contractions in endothelium-intact arteries from OZR. CONCLUSIONS: Endothelial dysfunction led to reduced neurogenic vasoconstriction in femoral arteries from OZR. In a setting of obesity, NO-dependent nNOS and iNOS dilation activity could be an alternative mechanism to offset COX-2- and reactive oxygen species-mediated vasoconstriction, along with impaired endothelial NO relaxation.

  2. Molecular Targets of Chromatin Repressive Mark H3K9me3 in Primate Progenitor Cells within Adult Neurogenic Niches

    Directory of Open Access Journals (Sweden)

    Michael R Foret

    2014-07-01

    Full Text Available Histone 3 Lysine 9 (H3K9 methylation is known to be associated with pericentric heterochromatin and important in genomic stability. In this study, we show that trimethylation at H3K9 (H3K9me3 is enriched in an adult neural stem cell niche- the subventricular zone (SVZ on the walls of the lateral ventricle in both rodent and non-human primate baboon brain. Previous studies have shown that there is significant correlation between baboon and human regarding genomic similarity and brain structure, suggesting that findings in baboon are relevant to human. To understand the function of H3K9me3 in this adult neurogenic niche, we performed genome-wide analyses using ChIP-Seq (chromatin immunoprecipitation and deep-sequencing and RNA-Seq for in vivo SVZ cells purified from baboon brain. Through integrated analyses of ChIP-Seq and RNA-Seq, we found that H3K9me3-enriched genes associated with cellular maintenance, post-transcriptional and translational modifications, signaling pathways, and DNA replication are expressed, while genes involved in axon/neuron, hepatic stellate cell, or immune-response activation are not expressed. As neurogenesis progresses in the adult SVZ, cell fate restriction is essential to direct proper lineage commitment. Our findings highlight that H3K9me3 repression in undifferentiated SVZ cells is engaged in the maintenance of cell type integrity, implicating a role for H3K9me3 as an epigenetic mechanism to control cell fate transition within this adult germinal niche.

  3. Clinical course of a cohort of children with non-neurogenic daytime urinary incontinence symptoms followed at a tertiary center

    Directory of Open Access Journals (Sweden)

    Adrienne Lebl

    2016-04-01

    Full Text Available Abstract Objective: To characterize a cohort of children with non-neurogenic daytime urinary incontinence followed-up in a tertiary center. Methods: Retrospective analysis of 50 medical records of children who had attained bladder control or minimum age of 5 years, using a structured protocol that included lower urinary tract dysfunction symptoms, comorbidities, associated manifestations, physical examination, voiding diary, complementary tests, therapeutic options, and clinical outcome, in accordance with the 2006 and 2014 International Children's Continence Society standardizations. Results: Female patients represented 86.0% of this sample. Mean age was 7.9 years and mean follow-up was 4.7 years. Urgency (56.0%, urgency incontinence (56.0%, urinary retention (8.0%, nocturnal enuresis (70.0%, urinary tract infections (62.0%, constipation (62.0%, and fecal incontinence (16.0% were the most prevalent symptoms and comorbidities. Ultrasound examinations showed alterations in 53.0% of the cases; the urodynamic study showed alterations in 94.7%. At the last follow-up, 32.0% of patients persisted with urinary incontinence. When assessing the diagnostic methods, 85% concordance was observed between the predictive diagnosis of overactive bladder attained through medical history plus non-invasive exams and the diagnosis of detrusor overactivity achieved through the invasive urodynamic study. Conclusions: This subgroup of patients with clinical characteristics of an overactive bladder, with no history of urinary tract infection, and normal urinary tract ultrasound and uroflowmetry, could start treatment without invasive studies even at a tertiary center. Approximately one-third of the patients treated at the tertiary level remained refractory to treatment.

  4. Influence of enrichment on behavioral and neurogenic effects of antidepressants in Wistar rats submitted to repeated forced swim test.

    Science.gov (United States)

    Possamai, Fernanda; dos Santos, Juliano; Walber, Thais; Marcon, Juliana C; dos Santos, Tiago Souza; Lino de Oliveira, Cilene

    2015-04-01

    Repeated forced swimming test (rFST) may detect gradual effects of antidepressants in adult rats. Antidepressants, as enrichment, affected behavior and neurogenesis in rats. However, the influence of enrichment on behavioral and neurogenic effects of antidepressants is unknown. Here, effects of antidepressants on rFST and hippocampal neurogenesis were investigated in rats under enriched conditions. Behaviors of male Wistar rats, housed from weaning in standard (SE) or enriched environment (EE), were registered during rFST. The rFST consisted of 15min of swimming (pretest) followed by 5min of swimming in the first (test), seventh (retest 1) and fourteenth (retest 2) days after pretest. One hour before the test, rats received an intraperitoneal injection of saline (1ml/kg), fluoxetine (2.5mg/kg) or imipramine (2.5 or 5mg/kg). These treatments were performed daily until the day of the retest 2. After retest 2, rats were euthanized for the identification of markers for neurogenesis in the hippocampus. Fluoxetine or imipramine decreased immobility in retests 1 and 2, as compared to saline. EE abolished these differences. In EE, fluoxetine or imipramine (5mg/kg) reduced immobility time in retest 2, as compared to the test. Independent of the housing conditions, fluoxetine and imipramine (5mg/kg) increased the ratio of immature neurons per progenitor cell in the hippocampus. In summary, antidepressants or enrichment counteracted the high immobility in rFST. Enrichment changed the effects of antidepressants in rFST depending on the type, and the dose of a substance but failed to change neurogenesis in control or antidepressant treated-rats. Effects of antidepressants and enrichment on rFST seemed neurogenesis-independent.

  5. Roles of TRPV1 and neuropeptidergic receptors in dorsal root reflex-mediated neurogenic inflammation induced by intradermal injection of capsaicin

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    Zou Xiaoju

    2007-10-01

    Full Text Available Abstract Background Acute cutaneous neurogenic inflammation initiated by activation of transient receptor potential vanilloid-1 (TRPV1 receptors following intradermal injection of capsaicin is mediated mainly by dorsal root reflexes (DRRs. Inflammatory neuropeptides are suggested to be released from primary afferent nociceptors participating in inflammation. However, no direct evidence demonstrates that the release of inflammatory substances is due to the triggering of DRRs and how activation of TRPV1 receptors initiates neurogenic inflammation via triggering DRRs. Results Here we used pharmacological manipulations to analyze the roles of TRPV1 and neuropeptidergic receptors in the DRR-mediated neurogenic inflammation induced by intradermal injection of capsaicin. The degree of cutaneous inflammation in the hindpaw that followed capsaicin injection was assessed by measurements of local blood flow (vasodilation and paw-thickness (edema of the foot skin in anesthetized rats. Local injection of capsaicin, calcitonin gene-related peptide (CGRP or substance P (SP resulted in cutaneous vasodilation and edema. Removal of DRRs by either spinal dorsal rhizotomy or intrathecal administration of the GABAA receptor antagonist, bicuculline, reduced dramatically the capsaicin-induced vasodilation and edema. In contrast, CGRP- or SP-induced inflammation was not significantly affected after DRR removal. Dose-response analysis of the antagonistic effect of the TRPV1 receptor antagonist, capsazepine administered peripherally, shows that the capsaicin-evoked inflammation was inhibited in a dose-dependent manner, and nearly completely abolished by capsazepine at doses between 30–150 μg. In contrast, pretreatment of the periphery with different doses of CGRP8–37 (a CGRP receptor antagonist or spantide I (a neurokinin 1 receptor antagonist only reduced the inflammation. If both CGRP and NK1 receptors were blocked by co-administration of CGRP8–37 and spantide I

  6. Electrophysiological monitoring and identification of neural roots during somatic-autonomic reflex pathway procedure for neurogenic bladder

    Institute of Scientific and Technical Information of China (English)

    DAI Cheng-fu; XIAO Chuan-guo

    2005-01-01

    Objective: To identify and separate the ventral root from dorsal root, which is the key for success of the artificial somatic-autonomic reflex pathway procedure for neurogenic bladder after spinal cord injury (SCI). Here we report the results of intra-operating room monitoring with 10 paralyzed patients.Methods: Ten male volunteers with complete suprasacral SCI underwent the artificial somatic-autonomic procedure under general anesthesia. Vastus medialis, tibialis anticus and gastrocnemius medialis of the left lower limb were monitored for electromyogram (EMG) activities resulted from L4, L5, and S1 stimulation respectively to differentiate the ventral root from dorsal root. A Laborie Urodynamics system was connected with a three channel urodynamic catheter inserted into the bladder. The L2 and L3 roots were stimulated separately while the intravesical pressure was monitored to evaluate the function of each root.Results: The thresholds of stimulation on ventral root were 0.02 ms duration, 0.2-0.4 mA, (mean 0.3 mA±0.07 mA), compared with 0.2-0.4 ms duration, 1.5-3 mA (mean 2.3 mA±0.5 mA)for dorsal root (P<0.01) to cause revoked potentials and EMG. Electrical stimulation on L4 roots resulted in the EMG being recorded mainly on vastus medialis, while stimulation on L5 or S1 roots caused electrical activities of tibialis anticus or gastrocnemius medialis respectively. The continuous stimulation for about 3-5 seconds on S2 or S3 ventral root (0.02 ms, 20 Hz, and 0.4 mA) could resulted in bladder detrusor contraction, but the strongest bladder contraction over 50 cm H2O was usually caused by stimulation on S3 ventral root in 7 of the 10 patients.Conclusions: Intra-operating room electrophysiological monitoring is of great help to identify and separate ventral root from dorsal root, and to select the appropriate sacral ventral root for best bladder reinnervation. Different parameters and thresholds on different roots are the most important factors to keep in mind to

  7. Current status and progress of the treatment of children neurogenic bladder%儿童神经源性膀胱治疗的现状及进展

    Institute of Scientific and Technical Information of China (English)

    罗意革; 黄名

    2013-01-01

    Children neurogenic bladder has a high incidence,which impairs the life and survival quality of children seriously,the treatment of which has been an unsettled world puzzle so far.Though the treatment of children neurogenic bladder has achieved great progress,the overall effect is still not satisfactory.At present,the treating methods are complex and varied,new technology is used in clinic continuously,the treating idea is updated continuously,so it is necessary to make a review about the current status and research progress of treatment in recent years.%儿童神经源性膀胱发病率高,严重危害患儿的生命与生存质量,其治疗是迄今尚未解决的世界难题.儿童神经源性膀胱的治疗已取得了巨大的进步,但总体效果仍欠理想,目前治疗方法复杂多样,新的技术不断应用于临床,治疗的理念不断被更新,因此有必要对近年来的治疗现状及研究进展做一综述.

  8. DYRK1A-mediated Cyclin D1 Degradation in Neural Stem Cells Contributes to the Neurogenic Cortical Defects in Down Syndrome

    Directory of Open Access Journals (Sweden)

    Sònia Najas

    2015-02-01

    Full Text Available Alterations in cerebral cortex connectivity lead to intellectual disability and in Down syndrome, this is associated with a deficit in cortical neurons that arises during prenatal development. However, the pathogenic mechanisms that cause this deficit have not yet been defined. Here we show that the human DYRK1A kinase on chromosome 21 tightly regulates the nuclear levels of Cyclin D1 in embryonic cortical stem (radial glia cells, and that a modest increase in DYRK1A protein in transgenic embryos lengthens the G1 phase in these progenitors. These alterations promote asymmetric proliferative divisions at the expense of neurogenic divisions, producing a deficit in cortical projection neurons that persists in postnatal stages. Moreover, radial glial progenitors in the Ts65Dn mouse model of Down syndrome have less Cyclin D1, and Dyrk1a is the triplicated gene that causes both early cortical neurogenic defects and decreased nuclear Cyclin D1 levels in this model. These data provide insights into the mechanisms that couple cell cycle regulation and neuron production in cortical neural stem cells, emphasizing that the deleterious effect of DYRK1A triplication in the formation of the cerebral cortex begins at the onset of neurogenesis, which is relevant to the search for early therapeutic interventions in Down syndrome.

  9. Quick note on tissue engineering-based surgical measures to treat patients with neurogenic bladder-due detrusor/sphincter dyssynergia.

    Science.gov (United States)

    Alberti, Contardo

    2015-01-01

    To treat the neurogenic bladder-due detrusor/urethral rhabdosphincter dyssynergia, early combined clean intermittent catheterization/ pharmacotherapy (anticholinergic-, β3-adrenoceptor agonist drugs) management may be at times crowned with success of preserving an adequate bladder compliance and renal safe conditions.The persistence, instead, of elevated bladder filling pressure levels with high voiding pressure/uroflow values, together with aberrant urethral rhabdosphincter electromyographic findings, make necessary the resort to surgery strategies, among which - a part from rhabdosphincterotomy or alternatively intrasphincteric botulinum A toxin injection or urethral stent insertion - the bladder augmentation cystoplasty, with either reconfigurated bowel- or gastric segment, is today the most efficacious surgical measure to increase the bladder urinary storage meanwhile lowering bladder filling pressure. Given the enterocistoplasty-dependent both potential systemic metabolic imbalances - such as hyperchloremic acidosis/hypokaliemia, hyperoxaluria, bone demineralization, chologenic diarrhoea/steatorrhoea, vit B12 deficiency - together with bowel prosthetic mucus overproduction-due recurrent stone formation, and, sometimes, malignant complications particularly at the intestinal-urinary tract suture line, tissue engineering techniques have been taken into consideration, more than twenty years ago, as alternative measure for bladder augmentation cystoplasty, until to reach successful clinical validation just in patients suffering from either congenital dysraphism- or acquired spinal cord injury-dependent neurogenic bladder. Nevertheless, also the tissue engineering-made augmentation cistoplasty, as well as that bowel-based one, unfortunately remains influenced by spinal cord neuropathydue dysfunctional effects, hence the tissue engineering research could be today directed to suitably overcome such disadvantageous conditions. PMID:26042661

  10. TGF-β superfamily gene expression and induction of the Runx1 transcription factor in adult neurogenic regions after brain injury.

    Directory of Open Access Journals (Sweden)

    Trevor T Logan

    Full Text Available Traumatic brain injury (TBI increases neurogenesis in the forebrain subventricular zone (SVZ and the hippocampal dentate gyrus (DG. Transforming growth factor-β (TGF-β superfamily cytokines are important regulators of adult neurogenesis, but their involvement in the regulation of this process after brain injury is unclear. We subjected adult mice to controlled cortical impact (CCI injury, and isolated RNA from the SVZ and DG at different post-injury time points. qPCR array analysis showed that cortical injury caused significant alterations in the mRNA expression of components and targets of the TGF-β, BMP, and activin signaling pathways in the SVZ and DG after injury, suggesting that these pathways could regulate post-injury neurogenesis. In both neurogenic regions, the injury also induced expression of Runt-related transcription factor-1 (Runx1, which can interact with intracellular TGF-β Smad signaling pathways. CCI injury strongly induced Runx1 expression in activated and proliferating microglial cells throughout the neurogenic regions. Runx1 protein was also expressed in a subset of Nestin- and GFAP-expressing putative neural stem or progenitor cells in the DG and SVZ after injury. In the DG only, these Runx1+ progenitors proliferated. Our data suggest potential roles for Runx1 in the processes of microglial cell activation and proliferation and in neural stem cell proliferation after TBI.

  11. DYRK1A-mediated Cyclin D1 Degradation in Neural Stem Cells Contributes to the Neurogenic Cortical Defects in Down Syndrome.

    Science.gov (United States)

    Najas, Sònia; Arranz, Juan; Lochhead, Pamela A; Ashford, Anne L; Oxley, David; Delabar, Jean M; Cook, Simon J; Barallobre, María José; Arbonés, Maria L

    2015-01-01

    Alterations in cerebral cortex connectivity lead to intellectual disability and in Down syndrome, this is associated with a deficit in cortical neurons that arises during prenatal development. However, the pathogenic mechanisms that cause this deficit have not yet been defined. Here we show that the human DYRK1A kinase on chromosome 21 tightly regulates the nuclear levels of Cyclin D1 in embryonic cortical stem (radial glia) cells, and that a modest increase in DYRK1A protein in transgenic embryos lengthens the G1 phase in these progenitors. These alterations promote asymmetric proliferative divisions at the expense of neurogenic divisions, producing a deficit in cortical projection neurons that persists in postnatal stages. Moreover, radial glial progenitors in the Ts65Dn mouse model of Down syndrome have less Cyclin D1, and Dyrk1a is the triplicated gene that causes both early cortical neurogenic defects and decreased nuclear Cyclin D1 levels in this model. These data provide insights into the mechanisms that couple cell cycle regulation and neuron production in cortical neural stem cells, emphasizing that the deleterious effect of DYRK1A triplication in the formation of the cerebral cortex begins at the onset of neurogenesis, which is relevant to the search for early therapeutic interventions in Down syndrome. PMID:26137553

  12. Exercise as a pro-cognitive, pro-neurogenic and anti-inflammatory intervention in transgenic mouse models of Alzheimer's disease.

    Science.gov (United States)

    Ryan, Sinéad M; Kelly, Áine M

    2016-05-01

    It is now well established, at least in animal models, that exercise elicits potent pro-cognitive and pro-neurogenic effects. Alzheimer's disease (AD) is one of the leading causes of dementia and represents one of the greatest burdens on healthcare systems worldwide, with no effective treatment for the disease to date. Exercise presents a promising non-pharmacological option to potentially delay the onset of or slow down the progression of AD. Exercise interventions in mouse models of AD have been explored and have been found to reduce amyloid pathology and improve cognitive function. More recent studies have expanded the research question by investigating potential pro-neurogenic and anti-inflammatory effects of exercise. In this review we summarise studies that have examined exercise-mediated effects on AD pathology, cognitive function, hippocampal neurogenesis and neuroinflammation in transgenic mouse models of AD. Furthermore, we attempt to identify the optimum exercise conditions required to elicit the greatest benefits, taking into account age and pathology of the model, as well as type and duration of exercise. PMID:27039886

  13. Sarcopenia, a Neurogenic Syndrome?

    OpenAIRE

    Ping Kwan

    2013-01-01

    Sarcopenia is an aging-associated condition, which is currently characterized by the loss of muscle mass and muscle strength. However, there is no consensus regarding its characterization hitherto. As the world older adult population is on the rise, the impact of sarcopenia becomes greater. Due to the lack of effective treatments, sarcopenia is still a persisting problem among the global older adults and should not be overlooked. As a result, it is vital to investigate deeper into the mechani...

  14. Diabetic Ulcer (Neurogenic Ulcer)

    Science.gov (United States)

    ... commonly occur on the pressure points of the foot: the ball, heel, and side of the foot if a person's shoes are too tight. However, ... streaking up the leg, drainage of the area, pain, foul odor, rising blood glucose, ... of the top of the foot. Your doctor may have you wear a special ...

  15. Fibromyalgi som neurogen smertetilstand

    DEFF Research Database (Denmark)

    Amris, Kirstine; Jespersen, Anders

    2010-01-01

    Fibromyalgia is characterised by chronic widespread pain and mechanical hyperalgesia. It is associated with a higher pain intensity, fewer pain-free intervals and more pronounced pain-related interference in function than other musculoskeletal pain conditions. Increasing evidence supports an unde...

  16. Stimulation of large-conductance calcium-activated potassium channels inhibits neurogenic contraction of human bladder from patients with urinary symptoms and reverses acetic acid-induced bladder hyperactivity in rats.

    Science.gov (United States)

    La Fuente, José M; Fernández, Argentina; Cuevas, Pedro; González-Corrochano, Rocío; Chen, Mao Xiang; Angulo, Javier

    2014-07-15

    We have analysed the effects of large-conductance calcium-activated potassium channel (BK) stimulation on neurogenic and myogenic contraction of human bladder from healthy subjects and patients with urinary symptoms and evaluated the efficacy of activating BK to relief bladder hyperactivity in rats. Bladder specimens were obtained from organ donors and from men with benign prostatic hyperplasia (BPH). Contractions elicited by electrical field stimulation (EFS) and carbachol (CCh) were evaluated in isolated bladder strips. in vivo cystometric recordings were obtained in anesthetized rats under control and acetic acid-induced hyperactive conditions. Neurogenic contractions of human bladder were potentiated by blockade of BK and small-conductance calcium-activated potassium channels (SK) but were unaffected by the blockade of intermediate calcium-activated potassium channels (IK). EFS-induced contractions were inhibited by BK stimulation with NS-8 or NS1619 or by SK/IK stimulation with NS309 (3µM). CCh-induced contractions were not modified by blockade or stimulation of BK, IK or SK. The anti-cholinergic agent, oxybutynin (0.3µM) inhibited either neurogenic or CCh-induced contractions. Neurogenic contractions of bladders from BPH patients were less sensitive to BK inhibition and more sensitive to BK activation than healthy bladders. The BK activator, NS-8 (5mg/kg; i.v.), reversed bladder hyperactivity induced by acetic acid in rats, while oxybutynin was ineffective. NS-8 did not significantly impact blood pressure or heart rate. BK stimulation specifically inhibits neurogenic contractions in patients with urinary symptoms and relieves bladder hyperactivity in vivo without compromising bladder contractile capacity or cardiovascular safety, supporting its potential therapeutic use for relieving bladder overactivity. PMID:24747752

  17. Pneumonia and in-hospital mortality in the context of neurogenic oropharyngeal dysphagia (NOD) in stroke and a new NOD step-wise concept.

    Science.gov (United States)

    Ickenstein, G W; Riecker, A; Höhlig, C; Müller, R; Becker, U; Reichmann, H; Prosiegel, M

    2010-09-01

    The aim of our work was to develop a step-wise concept for investigating neurogenic oropharyngeal dysphagia (NOD) that could be used by both trained nursing staff as well as swallowing therapists and physicians to identify patients with NOD at an early stage and so enable an appropriate therapy to be started. To achieve this objective, we assessed uniform terminology and standard operating procedures (SOP) in a new NOD step-wise concept. In-house stroke mortality rates and rates of pneumonia were measured over time (2003-2009) in order to show improvements in quality of care. In addition, outcome measures in a stroke-unit monitoring system were studied after neurorehabilitation (day 90) assessing quality of life (QL) and patient feedback. An investigation that was carried out in the context of internal and external quality assurance stroke projects revealed a significant correlation between the NOD step-wise concept and low rates of pneumonia and in-house mortality. The quality of life measures show a delta value that can contribute to "post-stroke" depression. The NOD step-wise concept (NSC) should, on the one hand, be capable of being routinely used in clinical care and, on the other, being able to fulfil the requirements of being scientifically based for investigating different stages of swallowing disorders. The value of our NSC relates to the effective management of clinical resources and the provision of adequate diagnostic and therapeutic options for different grades of dysphagia. We anticipate that our concept will provide substantial support to physicians, as well as swallowing therapists, in clinical settings and rehabilitation facilities, thereby promoting better guidance and understanding of neurogenic dysphagia as a concept in acute and rehabilitation care, especially stroke-unit settings.

  18. The Felix-trial. Double-blind randomization of interspinous implant or bony decompression for treatment of spinal stenosis related intermittent neurogenic claudication

    Directory of Open Access Journals (Sweden)

    Brand Ronald

    2010-05-01

    Full Text Available Abstract Background Decompressive laminotomy is the standard surgical procedure in the treatment of patients with canal stenosis related intermittent neurogenic claudication. New techniques, such as interspinous process implants, claim a shorter hospital stay, less post-operative pain and equal long-term functional outcome. A comparative (cost- effectiveness study has not been performed yet. This protocol describes the design of a randomized controlled trial (RCT on (cost- effectiveness of the use of interspinous process implants versus conventional decompression surgery in patients with lumbar spinal stenosis. Methods/Design Patients (age 40-85 presenting with intermittent neurogenic claudication due to lumbar spinal stenosis lasting more than 3 months refractory to conservative treatment, are included. Randomization into interspinous implant surgery versus bony decompression surgery will take place in the operating room after induction of anesthesia. The primary outcome measure is the functional assessment of the patient measured by the Zurich Claudication Questionnaire (ZCQ, at 8 weeks and 1 year after surgery. Other outcome parameters include perceived recovery, leg and back pain, incidence of re-operations, complications, quality of life, medical consumption, absenteeism and costs. The study is a randomized multi-institutional trial, in which two surgical techniques are compared in a parallel group design. Patients and research nurses are kept blinded of the allocated treatment during the follow-up period of 1 year. Discussion Currently decompressive laminotomy is the golden standard in the surgical treatment of lumbar spinal stenosis. Whether surgery with interspinous implants is a reasonable alternative can be determined by this trial. Trial register Dutch Trial register number: NTR1307

  19. 超声对类风湿关节炎患者腕关节病变的诊断价值%The Diagnostic Value of Ultrasound for Wrist Arthropathy of Patients with Rheumatoid Arthritis

    Institute of Scientific and Technical Information of China (English)

    张晓英; 田力; 陈荣杰; 安超

    2014-01-01

    目的:探讨超声对类风湿关节炎患者腕关节病变的诊断价值。方法:随机选取类风湿关节炎患者55例作为观察组,30例健康成年人作为对照组,分别进行腕关节超声检查,并抽取30例观察组患者对其行MRI检查。结果:超声可观察到类风湿关节炎患者腕关节不同程度滑膜增生、关节积液、肌腱腱鞘炎情况,其阳性检出率与MRI相比,差异无统计学意义(P>0.05),具有很高的一致性。MRI对类风湿关节炎患者腕关节骨侵蚀的检出率高于超声检查。结论:超声在诊断类风湿关节炎患者腕关节病变中,发挥着与MRI近乎相等的作用,可为临床对类风湿关节炎患者腕关节病变的诊断提供一种更简单经济的检查方法。%Objective:To investigate the diagnostic value of ultrasound for the wrist arthropathy of patients with rheumatoid arthritis.Methods:55 cases with rheumatoid arthritis were randomly selected as the observation group and 30 healthy adults were selected as the control group.The wrist ultrasound examination was made for them all to observe the thickness of synovium,blood lfow,joint effusion,tendons and bone cortex. 30 cases out of the observation group were selected for MRI examination.Results:Ultrasound could be used to observe synovium hyperplasia with different degree,joint effusion and tenosynovitis in patients with rheumatoid arthritis.The difference between the positive rate and the MRI was not significant (P > 0.05),while with great consistency.The detection rate of MRI for carpal bone erosion was higher than that of the ultrasonography. Conclusion:Ultrasound in the diagnosis of rheumatoid arthritis patients with carpal lesions played almost the same effect as MRI examination,which could provide a more simple and economic method for clinical diagnosis of wrist joint lesions in patients with rheumatoid arthritis.

  20. Total ankle prostheses in rheumatoid arthropathy

    Science.gov (United States)

    Schutte, Bernard; Louwerens, Jan Willem K; van den Hoogen, Frank H J; de Waal Malefijt, Maarten C

    2009-01-01

    Background and purpose The first generations of total ankle replacements (TARs) showed a high rate of early failure. In the last decades, much progress has been made in the development of TARs, with the newer generation showing better results. We evaluated TARs implanted with rheumatoid arthritis (RA) or juvenile inflammatory arthritis (JIA) as indication. Patients and methods 58 total ankle prostheses (Buechel-Pappas and STAR type) were implanted in patients with RA (n = 53) or JIA (n = 5) in 54 patients (4 bilateral). After a mean follow-up of 2.7 (1–9) years, all patients were reviewed by two orthopedic surgeons who were not the surgeons who performed the operation. Standard AP and lateral radiographs were taken and a Kofoed ankle score was obtained; this is a clinical score ranging from 0–100 and consists of sub-scores for pain, disability, and range of motion. Results 2 patients died of unrelated causes. Of the 52 patients who were alive (56 prostheses), 51 implants were still in place and showed no signs of loosening on the most recent radiographs. The mean Kofoed score at follow-up was 73 points (SD 16, range 21–92). 4 patients showed a poor result (score < 50) with persistent pain for which no obvious reason could be found. 5 implants were removed, 4 because of infection and 1 because of aseptic loosening. Interpretation Medium-term results of the STAR and BP types of TAR in RA were satisfactory. The main reason for failure of the implant was infection. PMID:19634020

  1. 脊髓损伤病人神经源性膀胱功能评估及分类研究进展%Research progress on classification and functional evaluation of neurogenic bladder in patients with spinal cord injury

    Institute of Scientific and Technical Information of China (English)

    樊帆; 汤爱玲; 叶文琴

    2015-01-01

    It summarized the research status quo of functional evaluation and classification method of neurogenic bladder of spinal cord inj ury patients.According to the inspection results,only the neurogenic bladder function of spinal cord inj ury patients was classified by nursing personnel,targeted individualized rehabilitation care was carried out for bladder function of spinal cord inj ury patients.%对脊髓损伤病人神经源性膀胱功能评估及分类方法研究现状进行综述,护理人员根据检查结果对脊髓损伤神经源性膀胱功能进行分类,才能对脊髓损伤病人膀胱功能进行针对性个性化的康复护理。

  2. Neurogenic Bladder in Lumbosacral Myelomeningocele%腰骶部脊髓脊膜膨出并发神经源性膀胱的临床研究

    Institute of Scientific and Technical Information of China (English)

    郑百俊; 李恭才; 张宪生; 徐泉; 高亚

    1997-01-01

    目的:随访、复查腰骶部囊性脊柱裂术后患儿,观察神经源性膀胱发病情况.方法:对38例行尿流动力学、排尿性膀胱尿道造影、B超及(或)静脉尿路造影检查.结果:①脊髓脊膜膨出占囊性脊柱裂的62%,脊髓脊膜膨出并发神经源性膀胱发病率为96%;②骨质缺损≥1.5 cm×1.5 cm者多为脊髓脊膜膨出(P<0.005);③共有8例上尿路功能受损者,残余尿量均≥60 ml,其中4例充盈期膀胱内压力≥1.96 kPa(20 cm H_2O),而3例膀胱逼尿肌-尿道括约肌协同失调者伞部出现膀胱输尿管返流.结论:①腰骶部囊性脊柱裂骨质缺损≥1.5 cm×1.5 cm者易并发神经源性膀胱;②允盈期膀胱内压力增高、膀胱逼尿肌-尿道括约肌协同失调、残余尿量明显增多是上尿路功能受损的危险因素.%Dept.of Pediat.Surgery,The 2nd Affiliated Hospital of Xian Medical University,Xian,710004Abstract Objective:To determine the incidence of neurogenic bladder among patients with spina bifida cystica in lumbosacral region.Methods:Urodyanmic studies,voiding cystourethrogram,B-uhrasonogram and/or intravenous urography were performed on 38 cases of spina bifida cystica.Results:1.Myeiomeningocele accounted for 62%of the lumbosacral spina bifida cystica and the incidence of neurogenic bladder in myelomeningocele was 96%;2.Spinal defect more than 1.5 cm×1.5 cm was indicative of myelomeningocele(P<0.005);and 3.Eight patients with upper urinary tract deterioration had residual urine more than 60ml.Four had filling intravesical pressure over 1.96 kPa(20 cm H_2O),3 had detrusor urinae disorder with vesicoureteral reflux.Conclusions:1.The diameter of spinal defect in cases of lumbosacral spina bifida cystica more than 1.5 cm are liable to have neurogenic bladder.2.Elevated filling intravesical pressure,detrusorsphincter dyssynergia and high residual urine are harmful factors of upper urinary tract deterioration.

  3. True neurogenic thoracic outlet syndrome in a competitive swimmer: a case report of this rare association Síndrome do desfiladeiro torácico verdadeiro em um nadador competitivo: relato de caso desta rara associação

    OpenAIRE

    Diogo Fraxino de Almeida; Meyer, Richard D.; Oh, Shin J.

    2007-01-01

    True neurogenic thoracic outlet syndrome (TOS) is an uncommon disorder despite of be a frequent reason for referral to the EMG laboratories. We describe the second case in the literature of true TOS in a competitive swimmer with progressive weakness and severe atrophy of the left thenar eminence. EMG showed lower trunk plexopathy. X-ray and MRI of the cervical spine and brachial plexus were normal. Surgical exploration evidenced the lower trunk retracted and pulled by a fibrous band. It was e...

  4. The neurogenic effects of exogenous neuropeptide Y: early molecular events and long-lasting effects in the hippocampus of trimethyltin-treated rats.

    Directory of Open Access Journals (Sweden)

    Valentina Corvino

    Full Text Available Modulation of endogenous neurogenesis is regarded as a promising challenge in neuroprotection. In the rat model of hippocampal neurodegeneration obtained by Trimethyltin (TMT administration (8 mg/kg, characterised by selective pyramidal cell loss, enhanced neurogenesis, seizures and cognitive impairment, we previously demonstrated a proliferative role of exogenous neuropeptide Y (NPY, on dentate progenitors in the early phases of neurodegeneration. To investigate the functional integration of newly-born neurons, here we studied in adult rats the long-term effects of intracerebroventricular administration of NPY (2 µg/2 µl, 4 days after TMT-treatment, which plays an adjuvant role in neurodegeneration and epilepsy. Our results indicate that 30 days after NPY administration the number of new neurons was still higher in TMT+NPY-treated rats than in control+saline group. As a functional correlate of the integration of new neurons into the hippocampal network, long-term potentiation recorded in Dentate Gyrus (DG in the absence of GABAA receptor blockade was higher in the TMT+NPY-treated group than in all other groups. Furthermore, qPCR analysis of Kruppel-like factor 9, a transcription factor essential for late-phase maturation of neurons in the DG, and of the cyclin-dependent kinase 5, critically involved in the maturation and dendrite extension of newly-born neurons, revealed a significant up-regulation of both genes in TMT+NPY-treated rats compared with all other groups. To explore the early molecular events activated by NPY administration, the Sonic Hedgehog (Shh signalling pathway, which participates in the maintenance of the neurogenic hippocampal niche, was evaluated by qPCR 1, 3 and 5 days after NPY-treatment. An early significant up-regulation of Shh expression was detected in TMT+NPY-treated rats compared with all other groups, associated with a modulation of downstream genes. Our data indicate that the neurogenic effect of NPY

  5. Imaging characteristic of orbital neurogenic tumors and clinical significance%眼眶神经源性肿瘤影像学特征及临床意义

    Institute of Scientific and Technical Information of China (English)

    岳岩; 魏锐利

    2009-01-01

    目的 探讨超声、CT及MRI对眼眶神经源性肿瘤的诊断价值.方法 收集长征医院眼科2004年1月至2007年11月经手术治疗,具有完整病理资料的眼眶神经源性肿瘤76例,回顾分析超声、CT、MRI检查的影像学表现.结果 各种眼眶肿瘤的影像学表现均有一定的特征性.超声检杳有利于揭示病变内的组织结构.CT利于显示病变的空间位置以及相邻结构的继发改变.MRI即可以显示病变的空间位置、病变蔓延情况.也可以通过显示信号强度提示病变的内部结构.结论 联合应用眼部超声、CT、MRI是发现和诊断眼眶肿瘤的重要检查手段,对大多数肿瘤可以做出明确定性、定位诊断.%Objective To probe value of ultrasound, CT and MRI in diagnosis of four major orbital neurogenic tumors including glioma,optic nerve sheath meningioma,neurilem- morea and neurofibroma. Methods 76 patients with orbital neurogenic tumors underwent operation in Changzheng hospital during January 2004-November 2007.The patients had complete pathological data,which were referred to to evaluate locating and identifying capacity of imaging methods including ultrasound,CT and MR1.Results Some orbital tumours have characteristic manifestations respectively in iconography.The value of ultrasound is that it can reveal the neoplasm structure interior,CT can reveal the location of the neoplasm and some changes secondarily, MRI is good at revealing the location of the neoplasm and the extension.Conclusions Combination use of ultrasound, CT and MRI.is an important examination method for diagnosing orbital neoplasms, and the diagnosis and differential diagnosis of orbital neoplasms in most cases can be made correctly.

  6. A co-culture model of the hippocampal neurogenic niche reveals differential effects of astrocytes, endothelial cells and pericytes on proliferation and differentiation of adult murine precursor cells

    Directory of Open Access Journals (Sweden)

    Fanny Ehret

    2015-11-01

    Full Text Available The niche concept of stem cell biology proposes a functional unit between the precursor cells and their local microenvironment, to which several cell types might contribute by cell–cell contacts, extracellular matrix, and humoral factors. We here established three co-culture models (with cell types separated by membrane for both adherent monolayers and neurospheres to address the potential influence of different niche cell types in the neurogenic zone of the adult hippocampus of mice. Astrocytes and endothelial cells enhanced precursor cell proliferation and neurosphere formation. Endothelial factors also led to a prolonged increase in proliferation after growth factor withdrawal, which otherwise induces differentiation. All niche cell types enhanced cell survival in monolayer cultures, endothelial cells also stimulated neuronal differentiation. A parallel trend elicited by astrocytes did not reach conventional statistical significance. Pericytes had variable effects here. We did not observe changes in differentiation in neurosphere co-cultures. In summary, our data indicate that in precursor cell culture protocols survival could be improved by adding as yet unknown factors physiologically contributed by astrocytes and endothelial cells. Our findings also underscore the complexity of the niche and the differential impact of factors from the different sources on distinct aspects of neuronal development. With the help of the models presented here, identification of these factors and their specific biological activity can now be initiated.

  7. Role of PiCCO monitoring for the integrated management of neurogenic pulmonary edema following traumatic brain injury: A case report and literature review

    Science.gov (United States)

    Lin, Xiaoping; Xu, Zhijun; Wang, Pengfei; Xu, Yan; Zhang, Gensheng

    2016-01-01

    Neurogenic pulmonary edema (NPE) is occasionally observed in patients with traumatic brain injury (TBI); however, this condition is often underappreciated. NPE is frequently misdiagnosed due to its atypical clinical performance, thus delaying appropriate treatment. A comprehensive management protocol of NPE in patients with TBI has yet to be established. The current study reported the case of a 67-year-old man with severe TBI who was transferred to our intensive care unit (ICU). On day 7 after hospitalization, the patient suddenly suffered tachypnea, tachycardia, systemic hypertension and hypoxemia during lumbar cistern drainage. Intravenous diuretics, tranquilizer and glucocorticoid were administered due to suspected left heart failure attack. Chest radiography examination supported the diagnosis of pulmonary edema; however, hypotension and hypovolemia were subsequently observed. Pulse index continuous cardiac output (PiCCO) hemodynamic monitoring and bedside echocardiography were performed, which excluded the diagnosis of cardiac pulmonary edema, and thus the diagnosis of NPE was confirmed. Goal-directed therapy by dynamic PiCCO monitoring was then implemented. In addition, levosimendan, an inotropic agent, was introduced to improve cardiac output. The patient had complete recovered from pulmonary edema and regained consciousness on day 11 of hospitalization. The current case demonstrated that PiCCO monitoring may serve a central role in the integrated management of NPE in patients with TBI. Levosimendan may be a potential medicine in treating cardiac dysfunction, along with its benefit from improving neurological function in NPE patients. PMID:27698733

  8. Progress on rehabilitation nursing of neurogenic dysphagia WANG%神经性吞咽困难康复护理的研究进展

    Institute of Scientific and Technical Information of China (English)

    王若婧; 黄燕梅; 许红璐

    2008-01-01

    Dysphagia is a commonly documented morbidity in neurology patients. Dysphasia can cause complications such as malnutrition, suffocation, pneumonia and death. Complications can not only influence the patients' quality of life, but also increase the overall healthcare expenditures. So it is highly needed to pay more attention to the assessment and rehabilitation of these patients. This review aims at systematically capturing current published literature about the methods for assessment and rehabilitation of neurogenic dysphagia.%吞咽困难在神经性失调患者中是一种常见的临床症状,神经性吞咽困难可引起多种并发症,降低患者生活质量,加重经济负担.为此,需重视该类患者的吞咽困难评估和康复.本文概述了神经性吞咽困难评估和康复护理的新进展.

  9. Inducible and targeted deletion of the ERK5 MAP kinase in adult neurogenic regions impairs adult neurogenesis in the olfactory bulb and several forms of olfactory behavior.

    Directory of Open Access Journals (Sweden)

    Yung-Wei Pan

    Full Text Available Although adult-born neurons in the subventricular zone (SVZ and olfactory bulb (OB have been extensively characterized at the cellular level, their functional impact on olfactory behavior is still highly controversial with many conflicting results reported in the literature. Furthermore, signaling mechanisms regulating adult SVZ/OB neurogenesis are not well defined. Here we report that inducible and targeted deletion of erk5, a MAP kinase selectively expressed in the adult neurogenic regions of the adult brain, impairs adult neurogenesis in the SVZ and OB of transgenic mice. Although erk5 deletion had no effect on olfactory discrimination among discrete odorants in the habituation/dishabituation assay, it reduced short-term olfactory memory as well as detection sensitivity to odorants and pheromones including those evoking aggression and fear. Furthermore, these mice show impaired acquisition of odor-cued associative olfactory learning, a novel phenotype that had not been previously linked to adult neurogenesis. These data suggest that ERK5 MAP kinase is a critical kinase signaling pathway regulating adult neurogenesis in the SVZ/OB, and provide strong evidence supporting a functional role for adult neurogenesis in several distinct forms of olfactory behavior.

  10. The neurogenic basic helix–loop–helix transcription factor NeuroD6 concomitantly increases mitochondrial mass and regulates cytoskeletal organization in the early stages of neuronal differentiation

    Directory of Open Access Journals (Sweden)

    Kristin Kathleen Baxter

    2009-09-01

    Full Text Available Mitochondria play a central role during neurogenesis by providing energy in the form of ATP for cytoskeletal remodelling, outgrowth of neuronal processes, growth cone activity and synaptic activity. However, the fundamental question of how differentiating neurons control mitochondrial biogenesis remains vastly unexplored. Since our previous studies have shown that the neurogenic bHLH (basic helix–loop–helix transcription factor NeuroD6 is sufficient to induce differentiation of the neuronal progenitor-like PC12 cells and that it triggers expression of mitochondrial-related genes, we investigated whether NeuroD6 could modulate the mitochondrial biomass using our PC12-ND6 cellular paradigm. Using a combination of flow cytometry, confocal microscopy and mitochondrial fractionation, we demonstrate that NeuroD6 stimulates maximal mitochondrial mass at the lamellipodia stage, thus preceding axonal growth. NeuroD6 triggers remodelling of the actin and microtubule networks in conjunction with increased expression of the motor protein KIF5B, thus promoting mitochondrial movement in developing neurites with accumulation in growth cones. Maintenance of the NeuroD6-induced mitochondrial mass requires an intact cytoskeletal network, as its disruption severely reduces mitochondrial mass. The present study provides the first evidence that NeuroD6 plays an integrative role in co-ordinating increase in mitochondrial mass with cytoskeletal remodelling, suggestive of a role of this transcription factor as a co-regulator of neuronal differentiation and energy metabolism.

  11. Identification of eight new mutations in familial neurogenic diabetes insipidus supports the concept that defective folding of the mutant provasopressin-neurophysin causes the disease

    Energy Technology Data Exchange (ETDEWEB)

    Rittig, S.; Siggaard, C.; Pedersen, E.B. [University Hospital in Aarhus (Denmark)] [and others

    1994-09-01

    Familial neurogenic diabetes insipidus (FNDI) is an autosomal dominant disorder with a uniform phenotype characterized by polyuria, polydipsia and a severe deficiency of arginine vasopressin (AVP). These abnormalities develop postnatally and appear to be due to progressive degeneration of AVP producing neurons. Previous studies in 8 FNDI kindreds have identified 5 different mutations in the gene that codes for the AVP-neurophysin (NP) precursor, AVP-NP. Four kindreds had the same missense mutation in the part of exon 1 that codes for the C-terminal amino acid of the signal peptide (SP). The other 4 had different missense mutations or a codon deletion in exon 2 which codes for the highly conserved part of NP. In the present study, the AVP-NP genes from 8 other kindreds with FNDI were sequenced bidirectionally using sequence and single-stranded DNA amplified by PCR with biotinylated primers flanking each of the 3 exons. We find that each of the 8 kindreds has a different, previously unreported mutation in either the SP coding part of exon 1, in exon 2 or in the variable, NP-coding part of exon 3. Combining these 8 new mutations with the 5 described previously reveals a distribution pattern that corresponds closely to the domains involved in the mutually interactive processes of AVP binding, folding and dimerization of NP. Based on these findings and the clinical features of FNDI, we postulate that the precursors produced by the mutant alleles are cytotoxic because they do not fold or dimerize properly for subsequent packaging and processing.

  12. Neurogenic detrusor overactivity is associated with decreased expression and function of the large conductance voltage- and Ca(2+-activated K(+ channels.

    Directory of Open Access Journals (Sweden)

    Kiril L Hristov

    Full Text Available Patients suffering from a variety of neurological diseases such as spinal cord injury, Parkinson's disease, and multiple sclerosis often develop neurogenic detrusor overactivity (NDO, which currently lacks a universally effective therapy. Here, we tested the hypothesis that NDO is associated with changes in detrusor smooth muscle (DSM large conductance Ca(2+-activated K(+ (BK channel expression and function. DSM tissue samples from 33 patients were obtained during open bladder surgeries. NDO patients were clinically characterized preoperatively with pressure-flow urodynamics demonstrating detrusor overactivity, in the setting of a clinically relevant neurological condition. Control patients did not have overactive bladder and did not have a clinically relevant neurological disease. We conducted quantitative polymerase chain reactions (qPCR, perforated patch-clamp electrophysiology on freshly-isolated DSM cells, and functional studies on DSM contractility. qPCR experiments revealed that DSM samples from NDO patients showed decreased BK channel mRNA expression in comparison to controls. Patch-clamp experiments demonstrated reduced whole cell and transient BK currents (TBKCs in freshly-isolated DSM cells from NDO patients. Functional studies on DSM contractility showed that spontaneous phasic contractions had a decreased sensitivity to iberiotoxin, a selective BK channel inhibitor, in DSM strips isolated from NDO patients. These results reveal the novel finding that NDO is associated with decreased DSM BK channel expression and function leading to increased DSM excitability and contractility. BK channel openers or BK channel gene transfer could be an alternative strategy to control NDO. Future clinical trials are needed to evaluate the value of BK channel opening drugs or gene therapies for NDO treatment and to identify any possible adverse effects.

  13. Pharmacological activation of CB2 receptors counteracts the deleterious effect of ethanol on cell proliferation in the main neurogenic zones of the adult rat brain

    Science.gov (United States)

    Rivera, Patricia; Blanco, Eduardo; Bindila, Laura; Alen, Francisco; Vargas, Antonio; Rubio, Leticia; Pavón, Francisco J.; Serrano, Antonia; Lutz, Beat; Rodríguez de Fonseca, Fernando; Suárez, Juan

    2015-01-01

    Chronic alcohol exposure reduces endocannabinoid activity and disrupts adult neurogenesis in rodents, which results in structural and functional alterations. Cannabinoid receptor agonists promote adult neural progenitor cell (NPC) proliferation. We evaluated the protective effects of the selective CB1 receptor agonist ACEA, the selective CB2 receptor agonist JWH133 and the fatty-acid amide-hydrolase (FAAH) inhibitor URB597, which enhances endocannabinoid receptor activity, on NPC proliferation in rats with forced consumption of ethanol (10%) or sucrose liquid diets for 2 weeks. We performed immunohistochemical and stereological analyses of cells expressing the mitotic phosphorylation of histone-3 (phospho-H3+) and the replicating cell DNA marker 5-bromo-2'-deoxyuridine (BrdU+) in the main neurogenic zones of adult brain: subgranular zone of dentate gyrus (SGZ), subventricular zone of lateral ventricles (SVZ) and hypothalamus. Animals were allowed ad libitum ethanol intake (7.3 ± 1.1 g/kg/day) after a controlled isocaloric pair-feeding period of sucrose and alcoholic diets. Alcohol intake reduced the number of BrdU+ cells in SGZ, SVZ, and hypothalamus. The treatments (URB597, ACEA, JWH133) exerted a differential increase in alcohol consumption over time, but JWH133 specifically counteracted the deleterious effect of ethanol on NPC proliferation in the SVZ and SGZ, and ACEA reversed this effect in the SGZ only. JWH133 also induced an increased number of BrdU+ cells expressing neuron-specific β3-tubulin in the SVZ and SGZ. These results indicated that the specific activation of CB2 receptors rescued alcohol-induced impaired NPC proliferation, which is a potential clinical interest for the risk of neural damage in alcohol dependence. PMID:26483633

  14. Nerve sheath tumor, benign neurogenic slow-growing solitary neurilemmoma of the left ulnar nerve: A case and review of literature

    Directory of Open Access Journals (Sweden)

    Martin Andra Elena

    2016-06-01

    Full Text Available This paper represent a report of a case with ulnar nerve schwannoma (neurilemmoma, benign neurogenic slow-growing, tumors originating from Schwann cells along the course of a nerve (1 (2 (3. Schwannomas are the most common tumors of the peripheral nerves which occur in the adults (0.8–2% (5. Usually they progress slowly and so they can remain painless swellings for a few years before other symptoms appear. Most of these lesions could be diagnosed clinically, are mobile in the longitudinal plane along the course of the involved nerve but not in the transverse plane (7. EMG, MRI, and ultrasonography are useful tools in the diagnosis. The definitive treatment of benign peripheral nerve schwannomatosis is complete enucleation of the tumor mass without damaging the intact nerve fascicles followed by confirmatory hystopathological examination (12. We present the case of a 62 years old right hand-dominant female who notice a slow increasing bulge over the inner aspect of her distal volar left forearm superior to the wrist, for a longer period of time not exactly specified; this was tracked and associated by pain, tingling and numbness over inner one and half fingers of her left hand in progress until the presentations. A diagnosis of soft-tissue tumor was presumed clinically. The other investigations were ultrasonography (US, nerve conduction studies (NCSs such as sensory nerve action potential (SNAP and compound muscle action potential (CMAP. In this case IRM was suggestive of a benign growth in her left ulnar nerve in the forearm region. Microsurgical techniques were used for ample enucleation of the tumor the distal volar left forearm. Subsequent histopathological examination confirmed the presumed diagnosis of a benign cellular schwannoma. At her last follow-up one month after surgery, the patient was neurological gradually improving sensory and motor function and she is highly satisfied with the results of surgery.

  15. 治脊疗法结合中频电治疗糖尿病性尿潴留的临床观察%Clinical observation of chiropractic therapy combined with intermediate frequency electricity in treatment of diabetic neurogen bladde

    Institute of Scientific and Technical Information of China (English)

    丁晓虹; 王潇; 廖军锋; 吕晓宇

    2012-01-01

    目的:观察治脊疗法结合中频电治疗糖尿病性尿潴留的临床疗效.方法:将糖尿病性尿潴留患者68例随机分为两组,实验组35例,采用治脊疗法结合中频电治疗;对照组33例,单纯采用中频电治疗.结果:实验组有效率为82.8%;对照组有效率为60.6%.两组比较差异有统计学意义(P<0.05).结论:治脊疗法结合中频电治疗糖尿病性尿潴留可明显提高疗效.%Objective: To observe the clinical efficacy of chiropractic therapy combined with intermediate frequency electricity in treatment of diabetic neurogen bladde. Methods: Sixty-eight patients with diabetic neurogen bladde were randomly divided into treatment group (n= 35) treated with chiropractic therapy combined with intermediate frequency electricity and control group ( n =33) treated with single intermediate frequency electricity. Results;The effective rate was 82. 8% in treatment group and 60. 6% in control group,with significant difference (P < 0. 05). Conclusion: The chiropractic therapy combined with intermediate frequency electricity might improve the efficacy of treatment for diabetic neurogen bladde.

  16. 前列腺增生合并神经系统疾病的尿动力学检查分析%The Analysis of Urodynamic Test in Treating BPH Complicated with Neurogenic Disease

    Institute of Scientific and Technical Information of China (English)

    卢绩; 王春喜; 侯宇川; 郝元元; 陈岐辉

    2012-01-01

    [ Objective ] To explore the directive significance of urodynamic test in treating BPH complicated with neurogenic disease. [Methods] We retrospectively analyze the urodynamic data of 144 cases of BPH patients with neurogenic disease, including P-Q nomogram and the detrusor contractility. [Results] Through P-Q nomogram, we found that 70 cases had definite bladder outlet obstruction and 32 cases had the equivocal status of bladder outlet obstruction. There were also 4 cases with bladder outlet unobstruction and 38 cases without P-Q nomogram detection for some reasons. 12 cases had bladder overactivity and 36 cases had detrusor underactivity or acontractile detrusor. [Conclusion] The urodynamic test is important for correct diagnosing BPH complicated with neurogenic disease. And it also helps doctors to choose the appropriate therapeutic schedule. If BPH complicated with neurogenic dis- , ease, the LUTS symptoms may attribute to bladder outlet obstruction caused by BPH, or the dysfunction of detrusor. Some of the patients do not have bladder outlet obstruction. The urodynamic test has directive significance in diagnosing and treating this kind of patients.%目的 探讨前列腺增生合并神经系统疾病患者的尿动力学检查对临床治疗的指导意义.方法 回顾分析我科收治的144例前列腺增生合并神经系统疾病患者的尿动力学资料,包括P-Q图及逼尿肌收缩能力的评价.结果 P-Q图提示膀胱出口梗阻70例,P-Q图提示膀胱出口梗阻不明确32例,P-Q图提示膀胱出口无梗阻4例,P-Q图未测出38例.逼尿肌过度活动12例,逼尿肌活动低下或收缩无力36例.结论 前列腺增生患者如合并有神经系统疾病,其下尿路症状既可由前列腺增生所致的膀胱出口梗阻引起,亦可由逼尿肌本身功能障碍所引起,部分患者并不存在膀胱出口梗阻;尿动力学检查对正确诊治此类患者具有指导意义.

  17. Research Progress in Rehabilitation Treatment on Neurogenic Bladder after Spinal Cord Injury%脊髓损伤后神经源性膀胱的康复治疗研究进展

    Institute of Scientific and Technical Information of China (English)

    王杰

    2015-01-01

    本文总结脊髓损伤后神经源性膀胱的病因病机、临床诊断及康复评定,分别介绍保守治疗、物理疗法、药物治疗、针灸疗法、手术治疗及其它康复方法的作用。%This paper summarizes the etiology and pathogenesis, clinical diagnosis and rehabilitation evaluation of neurogenic bladder after spinal cord injury, and respectively introduces the effect of conservative treatment, physical therapy, drug therapy, acupuncture therapy, operation therapy and other rehabilitation methods.

  18. Avaliação dos resultados da artroplastia parcial de ombro para tratamento da artropatia por lesão do manguito rotador Evaluating the results of partial shoulder arthroplasty for the treatment of arthropathy due to rotator cuff lesion

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    Sérgio Luiz Checchia

    2008-06-01

    Full Text Available OBJETIVO: Avaliar os resultados obtidos com a artroplastia parcial de ombro para o tratamento da artropatia por lesão do manguito rotador. MÉTODOS: No período de junho de 1989 a março de 2004, 11 ombros de 11 pacientes foram submetidos a artroplastia parcial de ombro para o tratamento de artropatia por LMR. O tempo de seguimento variou de 27 a 183 meses, com média de 69 meses. A idade média foi de 69,1 anos, variando de 44 a 78 anos. Houve predomínio do sexo feminino em 90,9% dos casos (10 pacientes. O membro dominante foi acometido em 10 pacientes. Os métodos escolhidos para avaliação dos pacientes, no seguimento pós-operatório, basearam-se nos critérios da UCLA; no índice de satisfação dos pacientes em relação ao alívio da dor; e no método de avaliação de objetivos limitados, proposto por Neer et al. RESULTADOS: O índice de satisfação dos pacientes em relação ao alívio da dor foi de 81,8%. Com o método de avaliação da UCLA, observamos média de 22,7 pontos. Por meio do método de avaliação de objetivos limitados, proposto por Neer et al, obtivemos seis pacientes com resultados satisfatórios e cinco insatisfatórios. CONCLUSÃO: A artroplastia parcial de ombro para o tratamento da artropatia por lesão do manguito rotador promove alívio do quadro doloroso e permite alguma melhora na função do membro para realização das atividades diárias; entretanto, é uma técnica que leva a altos índices de resultados insatisfatórios.OBJECTIVE: To evaluate the results achieved with partial arthroplasty of the shoulder to treat arthropathy due to rotator cuff lesion. METHODS: From June 1989 to March 2004, 11 shoulders of 11 patients were submitted to partial arthroplasty of the shoulder to treat an arthropathy due to rotator cuff lesion. Follow-up time varied from 27 to 182 months, with a mean of 69 months. Mean age was 69.1 years, ranging from 44 to 78 years. There was a predominance of the female gender, in 90.9% of

  19. 99mTc-亚甲基二磷酸全身骨关节显像在炎性关节病诊断中的意义%Role of 99mTc-MDP in whole body ECT for diagnosis of inflammatory arthropathy

    Institute of Scientific and Technical Information of China (English)

    宣丹; 杨继文; 程光华; 徐亮

    2012-01-01

    Objective: To investigate the clinical significance and variation of applying technetium methylenediphosphonate injection ( 99m Tc-MDP ) to bone emission computed tomography( ECT ) in diagnosis of inflammatory arthropathy. Methods: 99mTc- MDP ECT was performed in 45 patients with active inflammatory arthropathy, 21 rheumatoid arthritis ( RA ), 10 seronegative spondy loarthropathies( SPA ), 5 undifferentiated arthritis( UA ),5 osteoarthritis( OA ) and 4 gouty arthritis( GOUT ). Recorded in all patients were the swollen joint counts ( SJC ), tender joint counts( TJC ), erythrocyte sedimentation rate ( ESR ), C-reactive protein ( CRP ),levels of serum feritin( SFe ) and rheumatoid factor( RF ) in RA as well as nticyclic citrullinated peptide antibody( anti-CCP antibody ) besides the shiny joint counts in ECT for later assessment. Results: Positive effect of ECT was 95. 2% for RA patients compared to 66. 7% for non-RA( x2 =4.07 ,P <0.05 ). The shiny joint counts were positively correlated with SJC and TJC ( r = 0. 921, r = 0. 875, respectively,P < 0. 001 ),and the positive rates of ECT were higher than that in RF and CCP antibodies ( x2 = 5.559, x2 = 6. 929, respectively, P < 0. 05 ). Conclusion:99mTc-MDP ECT may expose the joint lesion involvements in patients with inflammatory arthropathy, and the agent dosage is an important index for estimation of the inflammation, specially for those of serum-negative RA cases.%目的:观察99mTc-亚甲基二磷酸(MDP)全身骨关节显像(ECT)在不同炎性关节病显像中的差别,结合临床资料研究其临床价值.方法:收集45例活动期炎性关节病患者,其中类风湿关节炎(RA)21例、血清阴性脊柱关节病(SPA)10例、未分化关节炎(UA)5例、骨关节炎(OA)5例、痛风性关节炎(GOUT)4例.记录患者的关节肿胀数(SJC)、关节压痛数(TJC)、红细胞沉降率(ESR)、C反应蛋白(CRP)、铁蛋白(SFe)及RA患者的类风湿因子(RF)、抗环状瓜氨酸肽抗体(抗CCP抗体).记

  20. Managing neurogenic bowel dysfunction: what do patients prefer? A discrete choice experiment of patient preferences for transanal irrigation and standard bowel management

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    Nafees B

    2016-02-01

    . Conclusion: Participants with bowel dysfunction regarded “risk of FI”, “frequency of use”, and “avoiding UTIs” as the most important features of a TAI device. These preferences are valuable in informing decision makers and clinicians regarding different bowel management solutions as well as for development of future devices. Keywords: neurogenic bowel dysfunction, UK, transanal irrigation, patient preference, discrete choice

  1. Relationship between neurogenic urination and psychological status in school children%学龄期儿童神经性尿频与心理状况关系的临床研究

    Institute of Scientific and Technical Information of China (English)

    李星; 林慧卿; 葛欣; 李玉峰

    2012-01-01

    目的 探讨焦虑、抑郁心理与学龄期儿童神经性尿频发生的关系.方法 选取136例9~ 12岁神经性尿频患儿为病例组,136例9~12岁健康儿童为对照组.以儿童焦虑性情绪障碍筛查表(SCARED)评价患儿焦虑心理,以儿童抑郁障碍自评量表(DSRSC)评价患儿抑郁心理,比较两组焦虑和抑郁的发生率以及两组SCARED和DSRSC评分,并运用logistic多元回归分析探讨焦虑和抑郁心理与神经性尿频发生的关系.结果 病例组焦虑和抑郁的发生率均高于对照组,差异有统计学意义(P<0.01).病例组SCARED评分(28.1±8.6)显著高于对照组(14.4±4.9)(P<0.01);DSRSC评分(13.5±4.8)亦显著高于对照组(9.1±3.2)(P<0.01).Logistic回归分析显示,SCARED筛查>23分者(即存在焦虑)神经性尿频发病风险为SCARED≤23者的1.224倍;DSRSC筛查≥15分者(即存在抑郁)神经性尿频发病风险为DSRSC< 15者的1.148倍.结论 焦虑和抑郁心理参与了学龄期儿童神经性尿频的发病.%Objective To study whether anxiety and depression are associated with the development of neurogenic urination in children. Methods A total of 136 9 to 12-year-old children with neurogenic urination (case group) and 136 age-matched healthy children (control group) were enrolled. The Screen for Children Anxiety Related Emotion Disorders (SCARED) and Depression Self-rating Scale for Children ( DSRSC) were used to evaluate the psychological status. The incidences of anxiety and depression as well as the SCARED and DSRSC scores were compared between two groups. Logistic regression analysis model was used to evaluate the relationship between psychological status and the development of neurogenic urination. Results The case group was found to have a higher incidence of anxiety and depression compared with the control group (P 23 ) had a 1.224-fold increased risk for the development of neurogenic urination compared with the children with the SCARED-score ≤ 23

  2. Classification and surgical treatment of spinal neurogenic foot deformity%脊髓神经源性足部畸形的分类和治疗

    Institute of Scientific and Technical Information of China (English)

    胡新永; 杨华清; 陈建文

    2012-01-01

    [目的]研究脊髓神经源性足部畸形的发病机理、分类和手术治疗方案.[方法]1988年10月~2006年6月,回顾性分析脊髓病变、脊髓和脊神经因被牵拉或压迫引起的足部畸形167例258足,根据脊髓损伤的性质和发病机理,将足部畸形分为上运动神经元损伤型和下运动神经元损伤型两大类,两类足部畸形采用不同的治疗方案.上运动神经元损伤型足部畸形,手术方案以选择性脊神经后根切断术或周围神经缩窄术为主;下运动神经元损伤型足部畸形,手术方案以软组织松解、肌腱转位术和截骨术为主,其中僵硬性足部畸形使用Ilizarov外固定器缓慢矫正.[结果]得到至少5年随访的147例228足进行总结分析,上运动神经元损伤型足部畸形42足,下运动神经元损伤型足部畸形186足.采用Laaveg-Ponseti足功能评分系统:优94足,良84足,可32足,差18足;优良率78.1%.第1次术后复发36足,复发率15.8%.第2次术后复发8足.[结论]根据脊髓神经源性足部畸形的分类,采用不同的手术治疗方案,可提高治疗效果,减少术后畸形复发.%[ Objective] To study the pathogenesis, classification and surgical treatment of spinal neurogenic foot deformity. [Methods] From October 1988 to June 2006, 167 cases (258 feet) treated with operation were statistically analysed retrospectively. The pathogenesis were spinal cord disease, with pulled and oppressed spinal cord or spinal nerves. Accoding to the characteristic and pathogenesis, the foot deformity was divided into two groups; the type of upper motor neurons injury and the type of lower motor neurons injury. Different operative methods were adopted to two different types. Foot deformity in the type of upper motor neurons injury were mainly treated with functionally selective posterior rhizotomy or tibiai neurotomy. Fool deformity in the type of lower motor neurons injury were mainly treated with soft tissue release

  3. Association between human parvovirus B19 and arthropathy in Belém, Pará, north Brazil Associação entre parvovírus B19 e artropatias em Belém, Pará, norte do Brasil

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    Ronaldo B. FREITAS

    2002-02-01

    Full Text Available A total of 220 patients with arthropathy were selected in Belém, Pará between January 1994 and December 2000, and screened for the presence of human parvovirus B19 IgM and IgG antibodies by enzyme-linked immunosorbent assay (ELISA. A subgroup (n = 132 of patients with high levels of antibodies (either IgM+/IgG+ or IgM-/IgG+ were examined for the presence of DNA by polymerase chain reaction/nested PCR. Recent/active infection (detection of IgM and/or IgG-specific antibodies and presence of viral DNA was identified in 47.7% of the 132 individuals with arthropathy. In our study, women were significantly more affected (59.7% than men (35.4% (P = 0.0006. The age group of 11-20 years (84.6%, among female patients, and 21-30 years (42.1%, among male, were those with the highest incidence rates. The analysis of the temporal distribution of B19-associated arthropaties showed a cyclic pattern, with peak incidence rates occuring at 3-5 year intervals. Significant diference (P = 0.01 was observed when comparing both the highest (39.0% and the lowest (11.0% seropositivity rates for the years of 1995 and 2000, respectively. The interfalangial joints of hands and feet were mostly affected, with 50.0% and 48.0% of cases among both women and men, respectively. In a smaller proportion, other joints such as those of knee, ankle, pulse and shoulder were affected. As for the duration, symptoms lasted 1 to 5 days in 54.0% of the individuals, whereas in 46.0% of them the disease lasted 6-10 days, if considered the subgroup (n = 63 of patients with recent/active infection by parvovirus B19. In our study, joint clinical manifestations occurred symmetrically. Our results indicate that B19 may be an important agent of arthropathies in our region, and this underscores the need for specific laboratory diagnosis when treating patients suffering from acute arthropathy, mainly pregnant women.Um total de 220 indivíduos portadores de artropatias foi selecionado em Belém, Par

  4. Understanding of Nursing Diabetes Complicated with Neurogenic Retention of Urine and Urinary Tract Mycotic Infection%糖尿病合并神经源性尿潴留、泌尿道真菌感染的护理体会

    Institute of Scientific and Technical Information of China (English)

    李柳芳; 顾华英; 巫织娥; 蔡秀英

    2002-01-01

    To treat patients with diabetic nearogenie bladder and neurogenic retention of urine by treating diabetes and evacuatingneurogenic retention of urine and restoring the function of the bladder. When the disease is complicated with urinary tract mycotic infection,the nursing become more important for the treatment.

  5. 急性脑损伤继发神经源性肺水肿%Neurogenic pulmonary edema secondary to acute central nervous system injury

    Institute of Scientific and Technical Information of China (English)

    梁锦泉; 冯子泽

    2013-01-01

    Objective To explore the pathogenesis and summarize the clinical characteristic and treatment experience of neurogenic pulmonary edema (NPE) secondary to acute central nervous system injury. Methods The data of 18 cases of NPE were retrospectively analyzed by reviewing medical literature. Results The age ranged from 19 to 69. The patients became acutely dyspneic, tachypneic and hypoxic following neurologic injury. Pink, frothy sputum was seen and bilateral crackles and rales were appreciated on auscultation. Chest X-ray or CT revealed diffuse bilateral pulmonary infiltrates. Eventually, they were cured by mechanical ventilation and other combined treatment. According to glasgow prognosis score, 13 cases of them got good recovery, 3 cases got moderate disability, 2 cases got severe disability. Conclusion NPE is characterized by the development of respiratory failure soon after neurologic injury. The primary therapy is to control the development of the damage to central nervous system, break the vicious circle, and apply mechanical ventilation, vascular active drugs and sedatives. After weaning, sputum suction via fiberoptic bronchoscopy shall be administered until the symptoms are relieved.%目的探讨脑损伤继发神经源性肺水肿的发病机制,总结其临床特点和救治经验。方法整理近年来18例急性脑损伤继发神经源性肺水肿病例的临床资料,并结合文献分析。结果患者19~69岁,均在急性脑损伤后出现呼吸困难,咳粉红色泡沫痰,血氧饱和度下降,双肺满布湿啰音,胸部CT/DR提示双肺弥漫性渗出性病变,最终经机械通气等综合处理后治愈。根据格拉斯哥预后评分(glasgow prognosis score,GOS),恢复良好(5分)13例,轻残(4分)3例,重残(3分)2例。结论急性脑损伤继发神经源性肺水肿的临床特点是均有急性脑损害的基础,短期内出现呼吸衰竭,基本救治方法是控制脑损伤的进展,打断

  6. Midterm outcomes of total hip arthroplasty for patients with end-stage haemophilic arthropathy%人工全髋关节置换术治疗终末期血友病性关节炎的中期疗效观察

    Institute of Scientific and Technical Information of China (English)

    翟吉良; 翁习生; 林进; 金今; 钱文伟

    2013-01-01

    背景:血友病性关节炎常累及多个关节,包括膝、踝和肘关节等,髋关节相对较少见,但其效果相对于其他髋关节疾病较差,骨结构异常、软组织挛缩、骨质较差以及术中术后出血是常见的影响因素。  目的:评估THA治疗终末期血友病性髋关节病变的临床及影像学结果。  方法:2002年5月至2012年6月行THA治疗21例(24髋)血友病性髋关节病变患者,20例为甲型血友病,1例为乙型血友病;年龄15~49岁,平均30.0岁。回顾性分析患者的一般资料、凝血因子水平、出血量和并发症情况,并随访髋关节Harris功能评分以及影像学结果。  结果:随访12~133个月,平均66个月。平均总出血量、显性出血量和隐性出血量分别为3559 ml(1494~7576 ml)、1441 ml (600~3440 ml)和2118 ml(534~4402 ml)。术中出血量和术后引流量平均为721 ml(300~2000 ml)和720 ml(200~2950 ml),平均输血量为5 U(0~14 U)。Harris评分由术前平均37分(15~81分)改善至末次随访时的平均93分(53~99分)。1例患者术中发生股骨近端劈裂骨折,1例发生深静脉血栓(DVT)。其他并发症包括皮肤溃疡合并血肿形成1例、一过性坐骨神经麻痹1例。所有假体均可见骨长入,无凝血因子抗体、感染、假体松动、骨溶解、应力遮挡、异位骨化和脱位等并发症。  结论:THA治疗终末期血友病性髋关节病变的中期随访临床及影像学结果良好,其成功的关键在于娴熟的手术技术、有效的凝血因子替代、采用非骨水泥型假体以及相关科室的团体合作。%Background:Haemophilic arthritis usually affects multiple joints-most commonly, the knee, ankle and elbow. Less com-monly involved is the hip. The therapeutic effect of haemophilic hip is poorer than other hip arthropathies. Excessive periop-erative bleeding, abnormal bone anatomy, poor bone

  7. 尿动力学检查对小儿神经源性膀胱手术方式选择的意义%Value of urodynamic study in making operation scheme for children with neurogenic bladder

    Institute of Scientific and Technical Information of China (English)

    刘颖; 毕允力; 范咏

    2014-01-01

    Objective To discuss the value of urodynamic study in making the operation scheme for children with neurogenic bladder.Methods Retrospective analyses were conducted for 41 cases with neurogenic bladder at our hospital.All of them finished such preoperative examinations including ultrasound,voiding cystourethrogram (VCUG) and dynamic renal scintigraphy with diethylenetriaminepentaacetic acid (DTPA).And 34 cases completed urodynamic studies.Results According to different clinical symptoms and examination results,individual operation scheme was formulated for each child.Blood transfusion was required for 21 cases.Postoperative complications occurred in 7 cases.And 39 cases had a follow-up period of 3 months to 5 years.Most children and their parents were satisfactory with recovery.Conclusions The operation schemes for children with neurogenic bladder may be individualized according to clinical symptoms and examination results.And urodynamic studies also play an important role in classification and treatment.%目的 探讨尿动力学检查对小儿神经源性膀胱手术方式选择的意义.方法 回顾性分析我院手术治疗的神经源性膀胱患儿的资料41例.所有患儿术前完成B型超声、排尿性膀胱尿道造影(voiding cystourethrogram,VCUG)、99mTc-DTPA肾动态显像(DTPA)、尿动力学检查.其中34例行储尿期+排尿期膀胱压力描记.结果 尿动力学检查提示逼尿肌过度活动23例,活动低下11例;括约肌过度活动21例,活动低下13例.根据患儿不同的临床症状,参考尿动力学检查结果,选用不同的手术方式.具体术式包括:回肠代膀胱扩大+阑尾代可控性膀胱流出道(Mitrofanoff)+阑尾代顺行结肠灌洗造瘘(Malone)+膀胱颈悬吊(Sling)2例,回肠代膀胱扩大+Mitrofanoff+ Sling 5例,回肠代膀胱扩大+输尿管再植+ Mitrofanoff+ Sling 7例,回肠代膀胱扩大+Mitrofanoff+右肾切除+Sling 1例,回肠代膀胱扩大+输尿管再植+ Mitrofanoff 18

  8. A new model of neurogenic hypertension: transcarotid modeling%经颅及颈动脉制作神经源性高血压模型的比较研究

    Institute of Scientific and Technical Information of China (English)

    刘佳; 夏大胜

    2011-01-01

    Objective: To compare the effect of neurogenic hypertension transcranial and transcarotid artery.Methods:24 dogs were randomly divided into two groups: transcarotid modeling group and transcranial modeling group.Renin activity (PRA), angiotensin Ⅱ(Ang Ⅱ ), aldosterone (Ald) and creatinine (Cr) were tested at preoperative and postoperative 1 week, 2 weeks, 4 weeks, 8 weeks, 12 weeks respectively.Results: After the surgery, systolic pressure and diastolic pressure of the two groups were significant higher than the basal blood pressure, but no difference was found between the two groups.The level of PRA, AnglI and Ald increased after modeling (P<0.05),but no difference was found between the two groups.Compared with transcranial modeling group, the amount of bleeding intraoperation and mortality postoperation was significantly higher in transcarotid modeling group.Conclusion: Transcranial and transcarotid modeling are effective methods in neurogenic hypertension, but transcarotid modeling of neurogenic hypertension is more simple, with low mortality and more suitable for large sample extension.%目的:比较经颅及经颈动脉制作神经源性高血压模型的效果.方法:选取24只杂种犬,随机分为两组(n=12),一组通过颈动脉鞘内血管搏动压迫脱髓鞘的迷走神经制作成神经源性高血压模型,另外一组经颅通过小脑前下或后下动脉对迷走神经和舌咽神经的长期搏动性压迫造模.分别应用有创血压监测、酶联免疫吸附、放射免疫等技术检测术前及术后1周、2周、4周、8周、12周两组犬的血压,抽取静脉血检验肾素活性、血管紧张素Ⅱ、醛固酮及肌酐等指标.结果:经两种不同方式造模后,在术后1周、2周、4周、8周、12周收缩压及舒张血压均明显高于造模前血压基础值,差异有统计学意义,两种造模方式造模后血压值未见明显差异.肾素活性、血管紧张素Ⅱ及醛固酮水平随造模

  9. 超声与磁共振成像对血友病骨关节病变诊断及评分的价值探讨%Diagnostic and score value of ultrasound and magnetic resonance imaging in hemophilia arthropathy

    Institute of Scientific and Technical Information of China (English)

    马菲; 孙竞; 周芳; 李颖嘉; 肖莉玲; 张丽; 罗淑仪; 罗婉贤; 张世玉; 洪少馥; 伍满香

    2016-01-01

    目的:以磁共振成像(MRI)对血友病骨关节病变诊断及评分结果为参照,探讨超声对血友病骨关节病变诊断及评分的价值。方法对42例血友病患者的42个关节(膝关节、踝关节、肘关节各14个)进行超声和 MRI 检查,比较超声与 MRI 对血友病患者关节病变检出的一致性,并对病变程度进行评分,比较两者评分的一致性。最后,比较超声检查评分者间的一致性和评分者自身的一致性。结果超声和 MRI 对于血友病患者关节早期软组织病变(关节积液/积血、滑膜增厚和含铁血黄素沉积)检出的一致性优秀(κ=0763~0896,P <0001),对软骨破坏检出的一致性优秀(κ=0793, P <0001),对骨边缘侵蚀检出的一致性差(κ=0133,P =0132),对软骨下骨囊肿检出的一致性差(κ=0100,P =0137)。超声与 MRI 对早期软组织病变评分的一致性为好至优秀(κ=0684~0833, P <0001),对晚期骨软骨病变(软骨破坏和骨破坏)评分的一致性为差至好(κ=0145~0635,P <0001)。超声对早期软组织病变的评分者间的一致性为好至优秀(κ=0676~0870,P <0001),对晚期骨软骨病变的评分者间的一致性为中等至优秀(κ=0421~0751,P <0001)。超声对早期软组织病变评分者自身的一致性为好至优秀(κ=0705~0885,P <0001),对晚期骨软骨病变的评分者自身的一致性为中等至好(κ=0532~0732,P <0001)。结论超声对于血友病骨关节疾病早期软组织病变以及软骨破坏的检出具有重要作用,有利于随访观察以及指导临床治疗。%Objective To explore the diagnostic and score value of ultrasound on hemophiliac arthropathy referring to MRI on the diagnosis and score of hemophiliac arthropathy Methods The ultrasound and MRI examinations were performed on 42 joints of 42 hemophilia patients 14 knees 14 ankles and 14 elbows The consistency of ultrasound and magnetic resonance imaging in the detection and score of joint diseases was compared Finally inter

  10. The F8(-/-) rat as a model of hemophilic arthropathy

    DEFF Research Database (Denmark)

    Christensen, Kristine Rothaus; Roepstorff, K.; Wiinberg, B.;

    2016-01-01

    . Methods Wild-type and F8(-/-) rats were treated with vehicle or recombinant human factor VIII (rhFVIII) prior to a needle-induced joint bleed. Joint swelling was measured prior to injury, the following 7 days and upon euthanasia. Histologic sections of the joint were stained, and athropathic changes...

  11. Genetics Home Reference: multicentric osteolysis, nodulosis, and arthropathy

    Science.gov (United States)

    ... to cut (cleave) a protein called type IV collagen. Type IV collagen is a major structural component of basement membranes, ... metallopeptidase 2 enzyme, preventing the normal cleavage of type IV collagen. It is unclear how a loss of enzyme ...

  12. Remedial sanation arthroscopy in gouty arthropathy of the knee joint

    Directory of Open Access Journals (Sweden)

    V V Lyalina

    2007-01-01

    Zaklyuchenie. Predlozhennaya avtorami metodika sanatsionnoy artroskopii znachitel'no rasshiryaet spektr lechebnykh vozmozhnostey i pozvolyaet optimizirovat' lechebnuyu taktiku pri khronicheskom podagricheskom artrite kolennogo sustava.

  13. Classification of knee arthropathy with accelerometer-based vibroarthrography.

    Science.gov (United States)

    Moreira, Dinis; Silva, Joana; Correia, Miguel V; Massada, Marta

    2016-01-01

    One of the most common knee joint disorders is known as osteoarthritis which results from the progressive degeneration of cartilage and subchondral bone over time, affecting essentially elderly adults. Current evaluation techniques are either complex, expensive, invasive or simply fails into detection of small and progressive changes that occur within the knee. Vibroarthrography appeared as a new solution where the mechanical vibratory signals arising from the knee are recorded recurring only to an accelerometer and posteriorly analyzed enabling the differentiation between a healthy and an arthritic joint. In this study, a vibration-based classification system was created using a dataset with 92 healthy and 120 arthritic segments of knee joint signals collected from 19 healthy and 20 arthritic volunteers, evaluated with k-nearest neighbors and support vector machine classifiers. The best classification was obtained using the k-nearest neighbors classifier with only 6 time-frequency features with an overall accuracy of 89.8% and with a precision, recall and f-measure of 88.3%, 92.4% and 90.1%, respectively. Preliminary results showed that vibroarthrography can be a promising, non-invasive and low cost tool that could be used for screening purposes. Despite this encouraging results, several upgrades in the data collection process and analysis can be further implemented.

  14. Pathogenic role of basic calcium phosphate crystals in destructive arthropathies.

    Directory of Open Access Journals (Sweden)

    Hang-Korng Ea

    Full Text Available basic calcium phosphate (BCP crystals are commonly found in osteoarthritis (OA and are associated with cartilage destruction. BCP crystals induce in vitro catabolic responses with the production of metalloproteases and inflammatory cytokines such as interleukin-1 (IL-1. In vivo, IL-1 production induced by BCP crystals is both dependant and independent of NLRP3 inflammasome. We aimed to clarify 1/ the role of BCP crystals in cartilage destruction and 2/ the role of IL-1 and NLRP3 inflammasome in cartilage degradation related to BCP crystals.synovial membranes isolated from OA knees were analysed by alizarin Red and FTIR. Pyrogen free BCP crystals were injected into right knees of WT, NLRP3 -/-, ASC -/-, IL-1α -/- and IL-1β-/- mice and PBS was injected into left knees. To assess the role of IL-1, WT mice were treated by intra-peritoneal injections of anakinra, the IL-1Ra recombinant protein, or PBS. Articular destruction was studied at d4, d17 and d30 assessing synovial inflammation, proteoglycan loss and chondrocyte apoptosis. BCP crystals were frequently found in OA synovial membranes including low grade OA. BCP crystals injected into murine knee joints provoked synovial inflammation characterized by synovial macrophage infiltration that persisted at day 30, cartilage degradation as evidenced by loss of proteoglycan staining by Safranin-O and concomitant expression of VDIPEN epitopes, and increased chondrocyte apoptosis. BCP crystal-induced synovitis was totally independent of IL-1α and IL-1β signalling and no alterations of inflammation were observed in mice deficient for components of the NLRP3-inflammasome, IL-1α or IL-1β. Similarly, treatment with anakinra did not prevent BCP crystal effects. In vitro, BCP crystals elicited enhanced transcription of matrix degrading and pro-inflammatory genes in macrophages.intra-articular BCP crystals can elicit synovial inflammation and cartilage degradation suggesting that BCP crystals have a direct pathogenic role in OA. The effects are independent of IL-1 and NLRP3 inflammasome.

  15. Knee arthropathy in ochronosis: diagnosis by arthroscopy with ultrastructural features.

    Science.gov (United States)

    Lurie, D P; Musil, G

    1984-02-01

    Knee arthroscopy in a patient with undiagnosed chronic monoarticular arthritis revealed dark pigmentation of the snyovium; synovial biopsy revealed histologic and ultrastructural features characteristic of ochronosis. Synovial fluid (SF) was non-inflammatory, without pigmented shards of cartilage; calcium pyrophosphate dihydrate crystals were absent in both the SF and biopsy specimen. Homogentisic acid was detectable in the urine by thin layer chromatography, and asymptomatic spondylosis with intervertebral disc calcification was found. The negative family history, lack of mucocutaneous pigmentation and failure of the urine to spontaneously darken obscured the diagnosis, which was easily made by arthroscopy. PMID:6699824

  16. 吞咽功能训练结合神经肌肉电刺激对神经源性吞咽功能障碍疗效的影响%Treating neurogenic dysphagia

    Institute of Scientific and Technical Information of China (English)

    李寄婧; 王正盛; 王建文; 杨敏

    2011-01-01

    目的 观察吞咽功能训练结合神经肌肉电刺激(NMES)治疗神经源性吞咽功能障碍(ND)的疗效,探讨ND治疗的更佳方案.方法 采用随机数字表法将82例患者分为3组,吞咽功能训练组(吞咽训练组)根据吞咽受累不同部位采用相应的训练方法,包括口颜面功能训练、咽部冷刺激、门德尔松吞咽法训练等,每日1次,每次30 min,10次为1个疗程;NMES组在吞咽功能障碍发生部位予以低频电刺激治疗,采用双向方波,波宽为700 ms,频率范围在30~80 Hz可调,电流强度为0~15 mA,每日1次,每次30 min,10次为1个疗程;综合治疗组(综合组)采用吞咽功能训练加NMES疗法.治疗前、后进行X线透视吞咽功能检查(VFSS),根据VFSS评分进行吞咽功能分级.结果 2个疗程后,3组患者吞咽功能均有不同程度的提高,吞咽训练组总有效率为73%、NMES组总有效率为83%、综合组总有效率为94%;综合组的VFSS分级结果显示,其吞咽功能明显优于吞咽训练组和NMES组(P<0.05).结论 吞咽功能训练加NMES治疗能更好地改善ND患者的吞咽功能,尤其是对假性延髓麻痹患者效果明显.%Objective To explore the best treatment program for neurogenic dysphagia (ND) by observing the efficacy of three different rehabilitation programs.Methods Eighty-two dysphagic patients were randomly divi-ded into a swallowing training group (which received mouth,facial,and tongue function training along with cold sti-mulation of the pharynx,Mendelson's swallowing training,and swallowing behavior coordination training) and a group which received neuromuscular electrical stimulation (NMES) only.Low-frequency NMES was applied at the location of the swallowing obstacle using a biphase square wave 700ms long at 30-80 Hz with a current intensity of 0-15 mA.There was also a combined treatments group which received swallowing behavior therapy combined with NMES.All three groups were treated for 30 min daily for 20 days

  17. The neurogenic basic helix-loop-helix transcription factor NeuroD6 enhances mitochondrial biogenesis and bioenergetics to confer tolerance of neuronal PC12-NeuroD6 cells to the mitochondrial stressor rotenone

    Energy Technology Data Exchange (ETDEWEB)

    Baxter, Kristin Kathleen; Uittenbogaard, Martine [Department of Anatomy and Regenerative Biology, George Washington University Medical Center, Washington, DC (United States); Chiaramello, Anne, E-mail: achiaram@gwu.edu [Department of Anatomy and Regenerative Biology, George Washington University Medical Center, Washington, DC (United States)

    2012-10-15

    The fundamental question of how and which neuronal specific transcription factors tailor mitochondrial biogenesis and bioenergetics to the need of developing neuronal cells has remained largely unexplored. In this study, we report that the neurogenic basic helix-loop-helix transcription factor NeuroD6 possesses mitochondrial biogenic properties by amplifying the mitochondrial DNA content and TFAM expression levels, a key regulator for mitochondrial biogenesis. NeuroD6-mediated increase in mitochondrial biogenesis in the neuronal progenitor-like PC12-NEUROD6 cells is concomitant with enhanced mitochondrial bioenergetic functions, including increased expression levels of specific subunits of respiratory complexes of the electron transport chain, elevated mitochondrial membrane potential and ATP levels produced by oxidative phosphorylation. Thus, NeuroD6 augments the bioenergetic capacity of PC12-NEUROD6 cells to generate an energetic reserve, which confers tolerance to the mitochondrial stressor, rotenone. We found that NeuroD6 induces an adaptive bioenergetic response throughout rotenone treatment involving maintenance of the mitochondrial membrane potential and ATP levels in conjunction with preservation of the actin network. In conclusion, our results support the concept that NeuroD6 plays an integrative role in regulating and coordinating the onset of neuronal differentiation with acquisition of adequate mitochondrial mass and energetic capacity to ensure energy demanding events, such as cytoskeletal remodeling, plasmalemmal expansion, and growth cone formation. -- Highlights: Black-Right-Pointing-Pointer NeuroD6 induces mitochondrial biogenesis in neuroprogenitor-like cells. Black-Right-Pointing-Pointer NeuroD6 augments the bioenergetic reserve of the neuronal PC12-NeuroD6 cells. Black-Right-Pointing-Pointer NeuroD6 increases the mitochondrial membrane potential and ATP levels. Black-Right-Pointing-Pointer NeuroD6 confers tolerance to rotenone via an adaptive

  18. True neurogenic thoracic outlet syndrome in a competitive swimmer: a case report of this rare association Síndrome do desfiladeiro torácico verdadeiro em um nadador competitivo: relato de caso desta rara associação

    Directory of Open Access Journals (Sweden)

    Diogo Fraxino de Almeida

    2007-12-01

    Full Text Available True neurogenic thoracic outlet syndrome (TOS is an uncommon disorder despite of be a frequent reason for referral to the EMG laboratories. We describe the second case in the literature of true TOS in a competitive swimmer with progressive weakness and severe atrophy of the left thenar eminence. EMG showed lower trunk plexopathy. X-ray and MRI of the cervical spine and brachial plexus were normal. Surgical exploration evidenced the lower trunk retracted and pulled by a fibrous band. It was excised and neurolysis of the plexus was done with gradual improvement of function. We discuss the possible pathophysiology of this association.A síndrome do desfiladeiro torácico verdadeiro é condição incomum, apesar de ser uma razão freqüente de encaminhamento aos laboratórios de eletroneuromiografia. Nós descrevemos o segundo caso na literatura desta doença rara em um nadador competitivo com fraqueza e atrofia severa da eminência tenar esquerda. A ENMG mostrou plexopatia do tronco inferior. O RX e as ressonâncias magnéticas da coluna cervical e do plexo braquial foram normais. Exploração cirúrgica mostrou o tronco inferior tracionado por uma banda fibrosa. Ela foi ressecada e procedeu-se a neurólise do plexo com melhora gradual da função. Nós discutimos a possível fisiopatologia desta associação.

  19. Curative effect observation of electroacupuncture combined with electronic biofeedback training in the treatment of neurogenic bladder%电针配合电子生物反馈训练治疗神经源性膀胱疗效观察

    Institute of Scientific and Technical Information of China (English)

    张惜瑜

    2015-01-01

    Objective:To study the effect of electroacupuncture combined with electronic biofeedback training in the treatment of neurogenic bladder.Methods:80 patients with neurogenic bladder were divided into groups.The treatment group was given electroacupuncture treatment and biofeedback training.The control group was given simple electroacupuncture treatment.The curative effects of patients in two groups were compared.Results:After treatment,there were significant differences between urinary function,maximum bladder capacity and infection rate and other indexes in two groups(P<0.05).Conclusion:Electroacupuncture combined with biofeedback training may help patients with neurogenic bladder to recover automatic micturition function and improve their quality of life.%目的:研究电针配合电子生物反馈训练治疗神经源性膀胱的效果.方法:将 80 例神经源性膀胱患者分组.治疗组给予电针治疗后辅之以生物反馈训练,对照组给予单纯性电针治疗.对比两组患者疗效.结果:治疗后两组排尿功能、膀胱最大容量及感染率等指标差异存在统计学意义(P<0.05).结论:电针结合生物反馈训练,可帮助治疗神经源性膀胱患者恢复自主排尿功能,改善其生活质量.

  20. Clinical analysis of positive end-expiratory pressure ventilation in the treatment of 64 cases with neurogenic pulmonary edema%采用呼气末正压通气治疗神经源性肺水肿64例临床观察

    Institute of Scientific and Technical Information of China (English)

    黄跃清; 叶少波; 王芳; 叶敏球

    2010-01-01

    Objective To investigate the positive end-expiratory pressure (PEEP) ventilation in the treatment of neurogenic pulmonary edema. Method 64 patients with neurogenic pulmonary edema were treated with the timely use of positive end-expiratory pressure(PEEP) ventilation. Then the curative effect was observed. Result The symptoms of hypoxia, pulmonary edema were had a rapid improvement in ventilation with PEEP. the improvementof heart rate, respiratory rate, oxygen saturation, partial pressure of oxygen, carbon dioxide partial pressure had significant difference compared with that before treatment(P < 0.01). Conclusion Neurogenic pulmonary edema patients treated with PEEP therapy had goved clinical effect.%目的 探讨采用呼气末正压(PEEP)通气治疗神经源性肺水肿的疗效.方法 对64例神经源性肺水肿患者经过及时采用PEEP通气治疗,观察临床治疗效果.结果 采用PEEP通气治疗后所有患者的缺氧症状、肺水肿体征均得迅速改善,与治疗前比较心率、呼吸频率、血氧饱和度、氧分压、二氧化碳分压的改善均具有统计学意义(P<0.01).结论 采用PEEP通气治疗神经源性肺水肿有较好的临床效果.

  1. Medial calcaneal nerve and neurogenic painful heel syndrome: anatomic basis%跟内侧神经与神经源性跟痛症关系的解剖学基础

    Institute of Scientific and Technical Information of China (English)

    冯成安; 孙俊; 刘宗良; 范炜; 张东葵; 叶频

    2012-01-01

    Objective To investigate the relationship between the medial calcaneal nerve (MCN) and neurogenic painful heel syndrome (NPHS), and provide anatomical evidence for study, diagnosis and therapy. Methods 32 formalin-fixed adult lower limb specimens were used in the study. MCN was dissected for demonstrating the origin, course, branches and the distribution. Results 41.42% of MCN originated from the trunk of tibial nerve, however, 28.57% originated from the bifurcation site of tibial nerve, 18.57% from the medial plantar nerve, and 11.42% from the lateral plantar nerve. The distance from the origin of MCN to the middle point between the lowest margin of the medial malleolus and the medial process of calcaneal tuberosity was about (30.22± 15.34)mm. MCN distributed to medial heel, the skin of footplate, and soft tissue of heel, after passing through flexor retinaculum. Conclusions MCN maybe compressed in the ankle canal, or the calcaneal tunnel, or at the site of passing from the flexor retinaculum, which are probably related to the occurrence of the plantar fasciitis and heel pain.%目的 探讨跟内侧神经的局部解剖特点及其与神经源性跟痛症的关系,为临床诊断治疗提供解剖学依据.方法 32侧防腐成人尸体下肢标本,解剖观察跟内侧神经的起源、分支、走行和分布特点.结果 跟内侧神经41.42%起源于胫神经,28.57%起源于胫神经分叉处,18.57%起源于足底内侧神经,11.42%起源于足底外侧神经.起点距O点(内踝尖最下缘与跟骨结节内侧突连线中点)(30.22±15.34)mm.跟内侧神经穿出屈肌支持带后分布于足跟内侧及跟底的皮肤和跟垫组织.结论 跟内侧神经在踝管内,浅出屈肌支持带处及跟管内可能被卡压;神经卡压或病变可能与足底腱膜炎发生及疼痛有关.

  2. 经皮电脉冲刺激治疗糖尿病神经源膀胱的疗效分析%The therapeutic effect of transcutaneous electrostimulation of vesica(TEV) in treatment of neurogenic bladder

    Institute of Scientific and Technical Information of China (English)

    王新民; 卢伟文; 李路; 郭跃安; 徐光; 周献忠; 骆新娥; 宋辛飞; 王玉麟

    2002-01-01

    目的观察体外电脉冲刺激膀胱(transcutaneous electrostimulation of vesica, TEV)对糖尿病神经源膀胱(diabetic neurogenic bladder,DNB)患者膀胱残余尿(bladder residue urine, BRU)和白细胞排泄率(urine leukocyte excretion rate,ULR)的影响,探讨DNB无创而有效的治疗方法. 方法所有BRU增多(≥50 ml)的DNB患者在降糖治疗的同时,根据其BRU的量分为轻(50~250 ml)、中(251~450 ml)、重(>450 ml)度DNB,轻、中度DNB患者分别随机分为刺激组和对照组,重度DNB患者则随机分为刺激组和刺激+α1-阻滞剂组,刺激均采用电脉冲体外交替刺激两侧膀胱角和膀胱前、后壁方位,使膀胱平滑肌不断收缩而排尿;主要观察指标有治疗前、后患者的血糖、血脂、BRU及ULR等变化. 结果 DNB患者的年龄、糖尿病病程、ULR、BRU和GHb随DNB的轻重而增加;而神经传导速度(nerve conductive velocity,NCV)则减慢.轻、中度DNB患者中,刺激组和对照组治疗前、后的糖、脂和尿酸代谢改善程度相当,但刺激组的BRU和ULR明显减少(P均<0.02),对照组则无明显变化;在重度DNB患者中,刺激组的BRU和ULR明显减少,尿意率(urine reflex rate,URR)明显升高,但刺激+α1-阻滞剂组BRU和ULR的减少较刺激组更明显. 结论体外膀胱电脉冲刺激可有效减少或消除DNB患者的BRU和ULR,甚至恢复重度DNB患者的尿意,在重度治疗DNB患者时与α1-阻滞剂联用疗效更佳.

  3. 肠道病毒71型致神经源性肺水肿机制研究进展%Research Progress in the Pathogenesis of Enterovirus 71 Induced Neurogenic Pulmonary Edema

    Institute of Scientific and Technical Information of China (English)

    钟涛(综述); 郑伟华; 李雄(审校)

    2015-01-01

    Enterovirus 71 ( EV71 ) , a-highly-neurotropic, positive-sense single-stranded RNA virus, belongs to the Enterovirus genus of Picornaviridae family.In recent decades,EV71 spreads mainly in main-land China,Taiwan,Malaysia and other Asia-pacific regions.EV71 infections mainly cause hand, foot, and mouth disease and herpangina in young children ,though it may also cause brain stem encephalitis ,and circu-lation problems,among which neurogenic pulmonary edema ( NPE) is one of the most serious complications and main causes of death.How EV71 infection causes NPE and its exact pathogenesis is still unclear .Here is make an elaboration focusing on the pathogenesis of EV71 infection combined with NPE from the aspects of abnormal secretion of catecholamine, cytokine abnormalities, immune disorder, respiratory myoparalysis, age, and gene etc.%肠道病毒71型(EV71)是有高度嗜神经性的正链RNA病毒,属于小RNA病毒科肠道病毒属,近几十年来,EV71在中国大陆、中国台湾、马来西亚等亚太地区流行。 EV71主要引起青少年手足口病和疱疹性咽峡炎,也可引起脑干脑炎等严重并发症,其中神经源性肺水肿( NPE)是最严重的并发症及主要死亡原因之一。 EV71感染引起NPE的确切发病机制仍不清楚。该文从儿茶酚胺分泌异常、细胞因子异常、免疫紊乱、呼吸肌麻痹、年龄及基因等方面对 EV71感染并发 NPE 的机制进行阐述。

  4. Effect of functional magnetic stimulation on the treatment of neurogenic bladder%功能性磁刺激治疗神经原性膀胱的疗效追踪

    Institute of Scientific and Technical Information of China (English)

    周宁; 陆敏; 黄晓琳; 丁新华

    2006-01-01

    BACKGROUND: Functional magnetic stimulation (FMS) is characterizedby safe, unwounded and non-side effect. At present, it has been used incentral nervous conduction, recovery from nervous exhaustion, bone healing, treatment of neural disorder, research of brain function, and so on;meanwhile, it also can improve urination dysfunction.OBJECTIVE: To pursue investigating the effect of FMS on the treatment of neurogenic bladder.DESIGN: Self controlled study pre- and post-treatment.SETTING: Department of Rehabilitation Medicine, Tongji Hospital,Tongji Medical College, Huazhong University of Science and Technique.PARTICIPANTS: Twenty patients with neurogenic bladder were recruited in the Department of Rehabilitation Medicine, Tong ji Hospital, Tongji Medical College, Huazhong University of Science and Technique from June 2003 to June 2004. Of them, 12 patients with neurogenic bladder were caused by spinal cord injury and 8 by other reasons under urinary dynamic examinations.METHODS: Twenty patients with neurogenic bladder underwent S3 never root and bladder FMS by MagLite magnetic stimulation system (Dantec Company, Denmark), for 20 successive times, twice a day, five days a week and 4-6 weeks as a course. The interval was 2 seconds and the frequency was 5 minutes for once. Parameters were designed as the following: intensity: 70%-80%maximal magnetic intensity; frequency: 5 Hz; impulse length: 1 ms.MAIN OUTCOME MEASURES: Parameters were observed pretreatment, post-treatment immediately and at 1 and 3 months: ① Urine frequency: the mean voided volume and the maximal voided volume; ②Scores of quality of life (QOL): Scores ranged from 0 to 6 points. The higher the scores were, the poorer the QOL was. ③ International lower urinary tract symptoms (LUTS) scores: There were 7 questions with the scores of 0-35. The higher the scores were, the severer the symptoms were.RESULTS: All 20 patients were involved in the final analysis. ① Effect of urination on QOL scores

  5. Hemodynamic parameters and neurogenic pulmonary edema following spinal cord injury: an experimental model Parâmetros hemodinâmicos e edema pulmonar neurogênico após traumatismo raquimedular: modelo experimental

    Directory of Open Access Journals (Sweden)

    Manoel Baldoino Leal Filho

    2005-12-01

    Full Text Available Neurogenic pulmonary edema is a serious and always life-threatening complication following several lesions of the central nervous system. We report an experiment with 58 Wistar-Hanover adult male rats. Two groups were formed: control (n=4 and experimental (n=54. The experimental group sustained acute midthoracic spinal cord injury by Fogarty’s balloon-compression technique containing 20µL of saline for 5, 15, 30 or 60 seconds. The rats were anesthetized by intraperitoneal (i.p. sodium pentobarbital (s.p. 60 mg/Kg. The quantitative neurological outcome was presented at 4, 24 and 48 hours from compression to characterize the injury graduation in different groups. Poor outcome occurred with 60 seconds of compression. Six animals died suddenly with pulmonary edema. Using the procedure to investigate the pulmonary edema during 60 seconds of compression, followed by decompression and time-course of 60 seconds, 20 rats were randomly asigned to one of the following groups: control (1, n=4, anesthetized by i.p. s.p., 60 mg/Kg but without compression and experimental (2, n=7, anesthetized by i.p. xylazine 10 mg/Kg and ketamine 75 mg/Kg and (3, n=9, anesthetized by i.p. s.p., 60 mg/Kg. The pulmonary index (100 x wet lung weight / body weight was 0.395 ± 0.018 in control group, rose to 0.499 ± 0.060 in group 2, and was 0.639 ± 0.14 in group 3. Histologic examination of the spinal cord showed parenchymal ruptures and acute hemorrhage. Comparison of the pulmonary index with morphometric evaluation of edema fluid-filled alveoli by light microscopy showed that relevant intra-alveolar edema occurred only for index values above 0.55. The results suggest that the pulmonary edema induced by spinal compression is of neurogenic nature and that the type of anesthesia used might be important for the genesis of lung edema.Edema pulmonar neurogênico é complicação séria e aumenta o risco de vida em pacientes com várias lesões do sistema nervoso central

  6. Neurogenic and neuroendocrine effects of goldfish pheromones.

    Science.gov (United States)

    Chung-Davidson, Yu-Wen; Rees, Christopher Benjamin; Bryan, Mara Beth; Li, Weiming

    2008-12-31

    Goldfish (Carassius auratus) use reproductive hormones as endocrine signals to synchronize sexual behavior with gamete maturation and as exogenous signals (pheromones) to mediate spawning interactions between conspecifics. We examined the differential effects of two hormonal pheromones, prostaglandin F(2alpha) (PGF(2alpha)) and 17alpha,20beta-dihydroxy-4-pregnen-3-one (17,20beta-P) on neurogenesis, neurotransmission, and neuronal activities, and on plasma androstenedione (AD) levels. Exposure to waterborne PGF(2alpha) induced a multitude of changes in male goldfish brain. Histological examination indicated an increase in the number of dividing cells in male diencephalon (p GnRH) in the male telencephalon and cerebellum (p chicken-II GnRH) in the female cerebellum (p < 0.05, one-way ANOVA). PGF(2alpha) and 17,20beta-P thereby seemed to act through distinct pathways to elicit different responses in the neuroendocrine system. This is the first finding that links a specific pheromone molecule (PGF(2alpha)) to neurogenesis in a vertebrate animal. PMID:19118184

  7. Intonation in Neurogenic Foreign Accent Syndrome

    Science.gov (United States)

    Kuschmann, Anja; Lowit, Anja; Miller, Nick; Mennen, Ineke

    2012-01-01

    Foreign accent syndrome (FAS) is a motor speech disorder in which changes to segmental as well as suprasegmental aspects lead to the perception of a foreign accent in speech. This paper focuses on one suprasegmental aspect, namely that of intonation. It provides an in-depth analysis of the intonation system of four speakers with FAS with the aim…

  8. Clinical Risk Factors of Neurogenic Pulmonary Edema in Patients with Severe Hand,Foot and Mouth Disease%重症手足口病并发神经源性肺水肿高危因素研究

    Institute of Scientific and Technical Information of China (English)

    张水路

    2012-01-01

    Objective To investigate risk factors of neurogenic pulmonary edema (NPE) in patients with severe hand, foot and mouth disease ( HFMD). Methods According to whether there was NPE or not , 56 patients with severe HFMD were divided into two groups. The difference of clinical symptoms , vital signs and the outcomes of laboratory examinations between the two groups were analyzed and the risk factors of NPE were analyzed by logistic regression analysis. Results The differences of EV71 infection rate, hyperthermia, tachypnea, tachycardia, hypertension, leukocytosis and hyperglycemia between two groups were statistically significant (P 0. 05 ). Logis-tic regression analysis showed that hyperglycemia , tachycardia, hypertension, tachypnea and leukocytosis were risk factors of NPE, and hyperglycemia was the most significant prognostic factor (OR =225. 000, P= 0.000).Conclusion Hyperglycemi-a, tachycardia, hypertension, tachypnea and leukocytosis were risk factors of NPE , and hyperglycemia is of great importance in predicting NPE.%目的 探讨重症手足口病并发神经源性肺水肿的高危因素.方法 根据有无并发神经源性肺水肿将56例重症手足口病患儿分为两组,分析两组在临床症状、体征、实验室检查结果之间的差异,Logistic回归分析并发神经源性肺水肿的高危因素.结果 两组在肠道病毒71型(EV71)感染、高热、呼吸急促、心动过速、血压升高、白细胞计数升高、高血糖方面差异均有统计学意义(P<0.05);两组发热持续时间≥3 d、呕吐、嗜睡、易惊、腱反射亢进、C反应蛋白升高发生率比较差异均无统计学意义(P>0.05).多因素Logistic回归分析显示:高血糖、心动过速、血压升高、呼吸急促、白细胞计数升高是神经源性肺水肿发生的危险因素,而且高血糖具有最大相对危险度(OR=225.000,P=0.000).结论 高血糖、心动过速、血压升高、呼吸急促、白细胞计数升高是神经源性肺

  9. Expression of neurogenic differentiation factor increased after transient hypoxia of hippocampal neurons in vitro%短暂性缺氧后海马神经元神经源性分化因子表达增高

    Institute of Scientific and Technical Information of China (English)

    刘晓艳; 徐剑文; 王玮

    2011-01-01

    目的 观察短暂性缺氧后神经源性分化因子(NeuroD)表达量的变化,探讨其在神经系统再生中的可能作用.方法 体外培养海马神经元,经神经元特异性烯醇化酶(NSE)免疫组织化学方法、尼氏体染色法鉴定.将培养5d的神经元置于三气培养箱(37℃、94%N2、5%CO2、1%O2)内缺氧培养.RT-PCR检测缺氧3h和6h后神经元NeuroD mRNA表达水平,电镜观察神经元形态学变化.将缺氧3h的神经元置于37℃、5%CO2培养箱中继续培养96h,固定前48h加入5-溴脱氧尿嘧啶核苷(BrdU)(终浓度为10μmol/L),免疫组织化学检测有无细胞增殖.结果 RT-PCR显示,缺氧3h后NeuroD表达量明显增高(P<0.01),而缺氧6h后NeuroD表达量与对照组相比差异无统计学意义(P>0.05).电镜结果显示,缺氧3h后细胞内细胞器未见明显变化,缺氧6h后细胞内出现空泡样变化,线粒体肿胀明显.免疫组织化学检测到BrdU阳性细胞.结论 短暂性缺氧后NeuroD表达量增高,可能参与了神经系统的再生过程.%Objective To observe the influence of transient hypoxia on the expression of neurogenic differentiation factor(NeuroD) in cultured neurons and investigate its possible roles in neural regeneration. Methods Influence of transient hypoxia on the expression of NeuroD was analyzed on the outcome of embryonic rat neurons in culture. Cultures at five days were exposed to hypoxia. After different periods(3 hours, 6 hours) of hypoxia, RT-PCR was performed to examine the mRNA levels of NeuroD. Electron microscopy was performed to observe neuronal alterations. Dishes after 3 hours hypoxia were then returned to normal atmosphere for ensuing culture 96 hours. Immunohistochemistry was performed to examine cell proliferation by incorporation of 5-bromodeoxyuridine ( BrdU ). Results Following hypoxia for 3 hours in cultured neurons, NeuroD increased distinctly and the incorporation of BrdU revealed an accumulation of proliferating cells.Compared with

  10. 肌电生物反馈治疗慢性神经源性吞咽障碍的临床观察%Electromyographic biofeedback therapy for treating chronic neurogenic dysphagia

    Institute of Scientific and Technical Information of China (English)

    郭钢花; 宋垒垒; 李哲

    2013-01-01

    Objective To observe the effect of electromyographic biofeedback therapy (EMG-BFT) on patients with dysphagia more than one month after stroke or traumatic brain injury.Methods Sixty-four patients with dysphagia were randomly divided into treatment group and control group.Both groups were given dysphagia training,while those in the treatment group were given EMGBFT and dysphagia training.VFSS and sEMG was conducted before and after treatment to assess swallowing function.Results Both groups demonstrated statistically and clinically significant improvements in swallowing function.The effective rate was 84.85% in treatment group and 55.56% in control group,with statistically significant difference between the two groups (P < 0.05).The improvement of swallowing function in the treatment group was significantly higher than that in control group (P < 0.05).Conclusions EMGBFT combined with swallowing behavior therapy can obviously improve swallowing function in patients with neurogenic dysphagia,and it is a effective therapy.%目的 观察肌电生物反馈对病程超过1个月的脑卒中或脑外伤患者吞咽障碍的影响.方法 选择64例慢性神经源性吞咽障碍患者,随机分为观察组和对照组,两组均给予吞咽训练,观察组在吞咽训练的基础上给予肌电生物反馈治疗,两组于治疗前及治疗4周后进行电视透视吞咽检查(VFSS)和表面肌电图检查.结果 两组患者治疗后吞咽功能均较治疗前改善,观察组的治疗有效率为84.85%,对照组为55.56%,两组患者在治疗前、后疗效比较差异均有统计学意义(P<0.05);观察组吞咽功能改善较显著,优于对照组,组间比较差异有统计学意义(P<0.05).结论 在吞咽训练的基础上使用肌电生物反馈辅助性治疗慢性神经源性吞咽障碍患者,能明显提高患者的吞咽功能,是一种有效的治疗方法.

  11. Substance P in Neurogenic Bowel Dysfunction after Spinal Cord Injury in Rats%大鼠脊髓损伤后P物质与神经源性肠道功能障碍的关系

    Institute of Scientific and Technical Information of China (English)

    龙志华; 高飞; 张锋良; 岳军忠; 王磊; 王烨; 刘文国; 徐青

    2014-01-01

    目的:探讨脊髓损伤后结肠中P物质与神经源性肠道功能障碍的关系。方法60只体质量(220±40) g的雄性Sprague-Dawley大鼠随机分为假手术组(n=20)、正常对照组(n=20)和模型组(n=20)。氯胺酮60 mg/kg腹腔注射麻醉大鼠,利用NYU脊髓打击器,以75 g⋅cm致伤力制作T10脊髓损伤模型,分别于造模后24 h、1周、3周和5周时切除大鼠结肠组织制作标本,检测肠道传输功能,采用ELISA方法测定血清中和组织中的P物质含量,实时荧光定量PCR和Western blotting法检测P物质mRNA和蛋白表达。结果模型组大鼠脊髓损伤后出现肠道传输功能下降,且于造模后3周时肠道传输达到最低值;造模后3周时模型组血清和组织中P物质含量与假手术组相比均降低,结肠组织中P物质的mRNA及蛋白表达水平也下调,与假手术组、正常对照组相比具有显著性差异,假手术组P物质的表达是模型组的(3.12±0.51)倍(P<0.05)。结论大鼠脊髓损伤后神经源性肠道功能障碍与结肠中P物质的表达降低有关。%Objective To investigate the relationship between neurogenic bowel dysfunction (NBD) and substance P in rats suffering from spinal cord injury (SCI). Methods 60 male Sprague-Dawley rats, weighted (220±40) g, were randomly divided into three groups:sham group (n=20), normal group (n=20) and model group (n=20) and then were subdivided into subgroups of 24 h, 1 week, 3 weeks, and 5 weeks respectively after SCI. SCI model was established at thoracic 10 segment of rat with NYU impactor device. The colon tissue of the rats was resected and stored. Substance P in serum and tissue was measured by ELISA. The tissue was examined by real-time RT-PCR and Western blotting to analyze the expression of substance P. Results The colon intestinal transmission function decreased and delineated at minimum value at 3 weeks in the model group. There was statistical significance with respect to the

  12. Ultrasonographic Diagnostic Neurogenic Tumors in the Neuroma of the Neck%超声检查对诊断颈部神经源肿瘤很有价值

    Institute of Scientific and Technical Information of China (English)

    牛丽娟; 郝玉芝; 周纯武; 戴景蕊; 谢敏

    2001-01-01

    ObjectiveTo further improve the sonographic diagnostic accuracy, we summarize the value of ultrasound for the neuroma of the neck. MethodsA retrospective analysis was performed on 48 cases with the neuroma of the neck. The results of preoperative ultrasonographic examination were compared with that of preoperative cytology and postoperative pathology. ResultsOf 48 neurogenic tumors in the neck, 47 were benign, its shape round or ellipse, its border clear, and inner echo uniform, the rate of cyst was 61.7%(29/47),the morphology of the cyst is the unique. The another one was malignant, the volume was bigger than that of the benigns, its border not clear, inner echo not uniform. Most of the tumors have the rich blood supply in colour Doppler sonography, 39 cases belong to II~III grade, and the blood supply is the unique. ConclusionThe diagnostic accurate rate is 85% for neuroma of the neck by ultrasound, preoperative sonographic examination is considered to be very significance in the diagnosis of the neuroma in the neck.%目的探讨并总结超声检查对颈部神经源肿瘤的价值,进一步提高诊断准确性。方法对48例患者行术前超声检查,并与穿刺细胞学及术后病理结果进行对照分析。结果47例良性颈部神经源肿瘤均为圆形或椭圆形肿物,边界清楚,内部回声均匀,其中多伴囊变61.7%(29/47),其囊变形态也有一定特点;另1例神经源肿瘤恶变,表现为肿物较大,边界不清,内部回声不均匀。彩超显示大部分病变血流较丰富,属II~III级,共计39例,检测部分病灶内血流情况发现有一定的特点。结论总结分析超声图像特点,注重颈部神经源肿瘤的诊断及鉴别诊断,其诊断正确率可达85%,术前超声检查对诊断颈部神经源肿瘤很有价值。

  13. 颈侧入路切除颈部椎管内外哑铃形神经源性肿瘤%Lateral cervical approach for resection of cervical dumbbell-shape neurogenic tumors

    Institute of Scientific and Technical Information of China (English)

    钱海鹏; 万经海; 李学记; 刘绍严

    2012-01-01

    Objective To study the indication and character of the lateral-cervical approach for treating dumble-shape neurogenic tumors in cervical spine.Methods Retrospectively review the clinical data of 14 dumble-shape neurogenic tumors in cervical spine,from October 2005 to October 2011.Among them 8 were males and 6 were females,range from 11 to 60 years old.The maximum tumor diameter range from 3.0 to 8.0 cm,with an average of 4.8 cm; the intraspinal tumor diameter range from 1.3 to 3.8 cm,with an average of 2.1 cm.According to Asazuma classification,9 cases were type Ⅱ c,2 cases were type Ⅲb,2 cases were type Ⅳ,1 case was type Ⅵ.Involving the neck segment C1-C2 in 1 case,C2-C3 in 1 case,C3-C4 in 2 cases,C4-C5 in 2 cases,C5-C6 in 3 cases,C6-C7 in 4 cases and C2-C4 in 1 case.All cases performed surgery with general anethesia.The head and neck surgeon performed surgery with lateral cervical approach,in the space between the anterior and the medius scalenus,exposed the transverse process and the intervertebral foramen as the anatomy marker,resected the extraspinal tumor part.The neurosurgery expanded the intervertebral foramen,and resected the intraspinal tumor with microscope,and repaired the dura.Then head and neck surgeon closed the wounds.Results Pathology proved 3 neurolimmoas and 11 Schwannomas,12 cases received gross total resection,2 cases received subtotal resection,the average blood loss during operation was 292 ml,the average operation time was 129 minutes,the average stay in hospital days was 7.1 days.The vertebral artery were exposed in 2 cases,and no vertebral artery injury occurred,there were 3 cases dissect the cervical nerve roots.No cerebrospinal fluidleakage,hematoma,newly branchial plexus injury,sympathic nerve injury or tracheal edema occured.In 3 to 24 months,with an average of 13.5 months follow-up period,2 cases with subtotal resection had no tumor progression,and 12 cases with gross total resection had no tumor recurrence.Conclusions Lateral

  14. Giant prostatic calculus with neurogenic bladder disease and prostate diverticulus:A case report and review of the literature%伴有神经源性膀胱和前列腺憩室的前列腺巨大结石1例报告并文献复习

    Institute of Scientific and Technical Information of China (English)

    李晓石; 权昌益; 李刚; 蔡启亮; 胡斌; 王久威; 牛远杰

    2013-01-01

    目的:探讨和总结伴有神经源性膀胱和前列腺憩室的前列腺巨大结石的病因、临床表现、诊断与治疗. 方法:结合相关文献复习并回顾性分析1例伴有神经源性膀胱和前列腺憩室的前列腺巨大结石患者的临床资料.患者男,37岁,尿失禁22年,间断排尿困难伴尿频9年,加重3个月.既往有脊柱裂及耻骨上膀胱切开取石术病史.术前尿常规:WBC 17 ~ 20/HPF,RBC 12 ~ 15/HPF.腹部平片(KUB)+静脉尿路造影(IVU)及盆腔CT:隐性脊柱裂,神经源性膀胱,前列腺巨大结石. 结果:患者行经尿道前列腺电切(TURP)+钬激光碎石术,结石成分为碳酸磷灰石.术后2周复查影像尿动力学:最大尿流率及残余尿量均明显好转.术后至今随访17个月,尿失禁较术前明显减轻,尿线粗. 结论:前列腺憩室合并前列腺巨大结石非常罕见,而神经源性膀胱可能为其发病的一个因素.膀胱镜检查是准确的检查方法.对于年轻和需要保留性功能者可采取TURP联合钬激光碎石术,术中结合直肠指检尽量彻底清除结石,术后密切随访.%Objective: To study the etiology, clinical manifestation, diagnosis and treatment of giant prostatic calculus with neurogenic bladder disease and prostate diverticulus. Methods: We retrospectively analyzed the clinical data of a case of giant prostatic calculus with neurogenic bladder disease and prostate diverticulus and reviewed the relevant literature. The patient was a 37-year-old man, with urinary incontinence for 22 years and intermittent dysuria with frequent micturition for 9 years, aggravated in the past 3 months. He had received surgery for spina bifida and giant vesico-prostatic calculus. The results of preoperative routine urinary examination were as follows: WBC 17 - 20 / HPF, RBC 12 - 15 / HPF. KUB, IVU and pelvic CT revealed spina bifida occulta, neurogenic bladder and giant prostatic calculus. Results: The patient underwent TURP and transurethral

  15. Application of PiCCO monitoring in patients with neurogenic pulmonary edema%PiCCO监测在神经源性肺水肿患者中的应用研究

    Institute of Scientific and Technical Information of China (English)

    吴绘; 马铁柱; 孙世中; 苏娅; 涂悦; 张赛

    2013-01-01

    Objective To evaluate the application of pulse induced contour cardiac output (PiCCO)monitoring in patients with neurogenic pulmonary edema (NPE),and to assess the accuracy of capacity parameters such as intra thoracic blood volume index (ITBVI) and global end diastolic volune index (GEDVI) and pressure parameters such as central venous pressure (CVP) in estimating severity of NPE,and to assess the prognostic significance of extravascular lung water index (EVLWI) on patients with NPE.Methods In this prospective study,36 patients with NPE in the department of neurological intensive care unit (NICU) underwent PiCCO monitoring,including mean arterial pressure (MAP),cardiac index (CI),CVP,ITBVI,GEDVI,EVLWI,pulmonary vascular permeability index (PVPI).The correlation between ITBVI,GEDVI,CVP and EVLWI was assessed.According to the outcome,these patients were divided into nonsurvivor group and survivor group.The change in EVLWI before and after treatment was compared between two groups.Results ITBVI,GEDVI were significantly and positively correlated with EVLWI,for the former r =0.54,P<0.001,and for the latter r=0.62,P<0.0001,but there was no significant correlation between CVP and EVLWI,r=0.12,P>0.05.PVPI,EVLWI were significantly and negatively correlated with oxygenation index (PaO2 / FiO2),for the former r=-0.55,P< 0.001,and for the latter r=-0.48,P<0.05.The difference in EVLWI (ml/kg) level before treatment between survivor group and nonsurvivor group was not statistically significant (8.6 ± 2.6 vs.9.4 ± 1.8,P>0.05).In survivor group,EVLW1 level obviously declined after treatment (6.92 ± 1.64 vs.8.64 ± 2.62,P<0.05),EVLWI level of survivor group was significantly lower than that of nonsurvivor group (6.92 ± 1.64 vs.9.88 ± 2.44,P<0.05).Conclusions Capacity parameters such as GEDVI,ITBVI can assess EVLWI of NPE patients accurately and reliably.In NPE patients,the higher the PVPI and EVLWI,the lower the PaO2 / FiO2.By dynamic observation of the trends

  16. The influence of spasmodic torticollis on the clinical prognosis of patients with neurogenic dysphagia%神经源性吞咽障碍伴痉挛性斜颈的临床治疗观察

    Institute of Scientific and Technical Information of China (English)

    郭钢花; 王国胜; 李哲

    2012-01-01

    目的 观察痉挛性斜颈对神经源性吞咽障碍患者康复预后的影响及不同治疗方法的疗效比较.方法 选取神经源性吞咽障碍患者103例,其中伴有痉挛性斜颈患者82例,采用随机数字表法分为单纯训练组(21例,仅给予常规吞咽康复训练)、药物训练组(21例,给予常规吞咽康复训练及药物治疗)、支持训练组(20例,给予常规吞咽康复训练及一般性支持治疗)及联合治疗组(20例,给予常规吞咽康复训练、药物及一般性支持治疗),余21例无痉挛性斜颈的神经源性吞咽障碍患者则归入无斜颈组(给予常规吞咽康复训练).于治疗前、治疗2个月对各组患者吞咽功能改善情况进行评定.结果 治疗前药物训练组、支持训练组、联合治疗组和单纯训练组吞咽功能均显著低于无斜颈组(P<0.05);各组患者分别经2个月治疗后,发现5组患者吞咽功能均较治疗前显著改善(P<0.05),其中药物训练组、支持训练组、联合治疗组和无斜颈组吞咽功能均显著优于单纯训练组(P<0.05);联合治疗组吞咽功能亦显著优于药物训练组及支持训练组(P<0.05);联合治疗组和无斜颈组吞咽功能组间差异无统计学意义(P>0.05).结论 痉挛性斜颈能影响神经源性吞咽障碍患者吞咽功能恢复,对痉挛性斜颈进行治疗可明显提高神经源性吞咽障碍患者吞咽功能.%Objective To observe the influence of spasmodic torticollis on the rehabilitation prognoses of patients with neurogenic dysphagia.Methods One hundred and three dysphagic patients were recruited,of which 82 had spasmodic torticollis and 21 did not.The subjects with spasmodic torticollis were divided randomly into a medication therapy group (21 cases) which accepted medication plus swallowing training,a common therapy group (20 cases) accepting common support treatment plus swallowing training,a combined therapy group (20 cases) accepting common support treatment

  17. 经皮肾动脉射频消融术对犬高血压影响机制的探讨%Efficacy of catheter-based renal denervation in mongrel neurogenic hypertensive dogs

    Institute of Scientific and Technical Information of China (English)

    卢成志; 刘少颖; 王丽; 刘佳; 夏大胜; 赵向东; 陈欣; 于翔; 徐建强; 张靖; 潘丽

    2012-01-01

    Objective Hypertension is the most common risk factor for cardiovascular diseases and stroke.Renal sympathetic hyperactivity is associated with hypertension.The aim of this study was to explore the efficacy of renal denervation for hypertension.Methods Eighteen mongrel neurogenic hypertensive dogs were divided into intervention[mean arterial pressure:(150.6 ± 18.8)mm Hg(1 mm Hg =0.133 kPa)plus renal sympathetic denervation by percutaneous catheter-based radiofrequency,n =10]and control [mean arterial pressure(147.4 ± 13.2)mm Hg,n =8]group.Mean arterial pressure before and at 2,4,6 and 10 weeks after procedure was invasively measured.Renin activity(PRA),angiotensin](Ang Ⅱ),aldosterone(Ald),and creatinine(Cr)were detected at 2,6 and 10 weeks after procedure.Results Mean arterial pressure remained unchanged in control group.In intervention group,mean arterial pressure(MAP)decreased to(130.4 ± 14.1)mm Hg,(136.2 ± 17.1)mm Hg,(128.7± 14.7)mm Hg and(126.1 ± 12.7)mm Hg respectively at 2,4,6,and 10 weeks after procedure.Meanwhile,the level of PRA,AngⅡ,Ald significantly reduced post procedure compared with pre-procedural level(P < 0.05)and the Cr level remained unchanged post procedure(P > 0.05).Conclusion Synpathetic nervous system plays animportant role in the progression of hypertension.Catheter-based renal denervation results in substantial and sustained blood-pressure reduction in this model.%目的 实验证明交感神经活性增强与高血压的发生有关,我们研究的旨在探讨去神经术对犬高血压的治疗,并评估其有效性与安全性.方法18只杂种犬随机分为干预组(n=10)和对照组(n=8)两组,制作成高血压模型,干预组给予经皮肾交感神经去神经化治疗,实验对照组仅造成高血压模型,不行干预治疗.观察平均血压的变化,分别在术前和术后2、4、6、10周监测血压,同时在术后第2、6、10周监测血肾素活性、血管紧张素Ⅱ、醛固酮和肌酐等指标,通过

  18. 激活态雪旺细胞源性神经营养因子对胚芽干细胞向神经细胞分化的影响%Activated Schwann cells-derived neurotrophins induce mouse embryonic germ cells differentiation into neurogenic cells

    Institute of Scientific and Technical Information of China (English)

    曹代桂; 周先虎; 冯世庆; 陈家童; 孔晓红; 郝岩

    2013-01-01

    Objective To seek an optimal method for the separation,culture of mouse embryonic germ cells (EGCs) in vitro,and to observe the influence of Activated Schwann cells (ASCs)-derived neurotrophins on the differentiation capability of mouse EGCs into neurogenic cells.Methods The gonadal ridges and a few abdominal tissues of the 11-day postcoitum (dpc) mouse embryos were isolated and disaggregated by 0.125% trypsin-0.02% EDTA,followed by culture of the mouse EGCs on mouse embryonic fibroblast (MEF) feeders.Monoclonal formation of the mouse EGCs was observed,and the staining of stage specificity embryo antigen-1 (SSEA-1),alkaline phosphatase (AKP),periodic acid-Schiff staining (PAS) were applied to identify the mouse EGCs.Two groups were divided as followed:mouse EGCs+basic medium (control group) and mouse EGCs+ASCs (experimental group).Immunofluorescence (NeuN,MBP,GFAP)analysis was used to evaluate the neurogenic differentiation of mouse EGCs and then to calculate the statistical positive rates of cell staining.All experimental results were analyzed statistically.Results (1) Identification ofmouse EGCs:Mouse EGCs were characterized by a dome-shaped colony containing a large nucleus and a relatively small amount of cytoplasm.All mouse EGCs were positive staining of SSEA-1,AKP,and PAS;(2)The neural induction of mouse EGCs:After one week induction,there were few round or oval cells with long axon-like processes migrating from the edge of the EGCs clones.3 weeks later,the neurogenic-like cells increased quickly.The results of immunofluorescence (NeuN,MBP,GFAP)staining demonstrated that mouse EGCs could differentiate into neurogenic cells under the influence of ASCs.The positive rate of cell staining was significant.Conclusion In this study,a simple,economical method was applied to successfully separate the mouse EGCs in vitro; mouse EGCs can differentiate into neurogenic cells under the influence of ASCs-derived neurotrophins.%目的

  19. 间歇导尿更换卧位对脊髓伤致神经源性膀胱患者泌尿系感染的影响%Intermittent catheterization to replace lie on spinal cord injury patients with neurogenic bladder Urinary tract infection

    Institute of Scientific and Technical Information of China (English)

    黄学英; 王丽华; 柳尧花

    2013-01-01

    目的:探讨无菌间歇导尿(Sterile Intermittent Catheterization,SIC)更换卧位对脊髓损伤(spinal cord injury ,SCI)致神经源性膀胱功能障碍( neurogenic bladder ,NB),泌尿系感染( urinary tract infection ,UTI)并发症的影响。方法:SCI符合美国脊髓损伤学会(American Spinal Injury Association , ASIA)2011年标准;NB符合亚洲神经源性膀胱诊断治疗指南(2011版)的诊断标准。患者115例患者分为对照组56例,观察组59例,2组患者制定饮水计划并书写排尿日记,接受常用的膀胱功能训练,SIC,观察组导尿后采取更换卧位,分别叩击耻骨上、骶尾部和右侧/或左侧臀部,2次夹闭尿管、3次开放彻底引流尿液。观察指标:血常规、尿常规、细菌培养、肾功能、B超等辅助检查,每次导尿时观察尿液的物理状态。结果:2组患者UTI的发生随间歇导尿呈减少趋势,但对照组经过3周的间歇导尿UTI发生并无减少。观察组与照组比较3周后有显著性差异(P∠0.01)。结论:SIC更换卧位引流尿液,能有效降低SCI致NB患者UTI的发生。%Objective:To discuss sterile Intermittent Catheterization replace the lying position of spinal cord injury , cause neurogenic bladder dysfunction urinary tract infection complications.Methods:SCL conforms to the American Spinal Injury Association 2011 standard;NB in Asian neurogenic bladder guide (2011) diagnostic criteria for the diagnosis and treatment.56 cases patients, 115 patients were divided into control group, 59 cases of observation group, 2 groups of patients developed a plan of drinking water and voiding diary writing , commonly used bladder function training, SIC, Observation group after urethral catheterization to replace recumbent position , respectively the taps on the pubic bone, the tail and/or on the right side on the left side of the hips,, turn off 2 times, 3 times open drainage of urine

  20. 不同剂量肉毒素A注射治疗神经源性逼尿肌过度反射患者的有效性%Efficacy of different dose of Botulinum toxin A in treatment of patients with neurogenic detrusor overactivity

    Institute of Scientific and Technical Information of China (English)

    唐偲; 沈宏

    2016-01-01

    目的:研究不同浓度肉毒素 A 注射治疗脊髓损伤或者多发性硬化症所导致的神经源性逼尿肌过度反射的作用。方法统计我院2011年6月至2014年12月收治的43例由脊髓损伤或者多发性硬化症所导致的神经源性逼尿肌过度反射患者,完成12周的随访时患者总数为38例,其中20例患者给予200 U 剂量的肉毒素 A(200 U 组),18例患者给予100 U 剂量的肉毒素 A (100 U 组)。38例患者的平均年龄为45.3岁,女性比例高于男性。随访并记录6周及12周后尿失禁患者生活质量(I-QOL)评分相对于基线评分的变化。结果随访结束后,总体 I-QOL 得分的比较显示,200 U 组患者明显高于100 U 组,差异具有统计学意义(P <0.05)。结论肉毒素 A 注射治疗神经源性逼尿肌过度反射有一定的效果,而且200 U 的剂量效果强于100 U。%Objective To research the efficacy of different dose botulinum toxin A in the treatment of patients with neurogenic detrusor overactivity due to spinal cord injury or multiple sclerosis.Methods The datas of 43 patients with neurogenic detrusor overactivity caused by spinal cord injury or multiple sclerosis which accepted treatment in our hostipal were analyzed.And 38 patients were followed up for 12 weeks,of which 20 cases were treated with 200 U botulinum toxin A,and 18 cases received 100 U botulinum toxin A.The average age of 38 patients was 45.3 years old,and the ratio of famale was higher.The incontinence quality of life(I-QOL)changed from baselin after 6 weeks and 12 weeks was recorded.Resluts The final outcomes showed that the efficacy of botulinum toxin A with 200U was better than that with 100 U according to I-QOL score,and the difference was statistical significance(P <0.05).Conclusion The botulinum toxin A has positive effect on neurogenic detrusor overactivity,and the efficacy of 200 U injection is better than that of 100 U.

  1. 手足口病并发神经源性肺水肿患儿血清C反应蛋白及糖蛋白KL-6变化的研究及护理%Research in variation of C-reactive protein and glycoprotein KL-6 in children patients with handfoot and mouth disease complicated with neurogenic pulmonary edema and nursing

    Institute of Scientific and Technical Information of China (English)

    陈春娇

    2012-01-01

    目的 研究血清C反应蛋白(CRP)及糖蛋白KL-6在手足口病并发神经源性肺水肿患儿中的含量变化隋况,并探讨相关护理措施,为手足口病并发神经源性肺水肿的诊断提供依据.方法 随机选取2010年1月至2011年6月我院收治的96例手足口病并发神经源性肺水肿患儿,其中56例为重型患儿(重型组),40例为普通型患儿(普通组),另外随机选取同期年龄相仿的48例健康儿童(健康组),采用比浊法测定3组儿童的血清CRP含量,采用Elisa法测定糖蛋白KL-6的含量,对所测结果进行比较分析,总结手足口病的相关护理措施.结果 比浊法测定检测CRP的结果显示,重型手足口病并发神经源性肺水肿患儿的CRP含量最高,普通型次之,健康组正常.Elisa法测定糖蛋白KL-6的结果显示,重型手足口病并发神经源性肺水肿患儿含量最高,普通型次之,健康组正常.数据分析发现3组儿童的上述2种指标的检测结果差异均有统计学意义.结论 通过比较分析发现CRP及糖蛋白KL-6的含量与手足口病并发神经源性肺水肿的严重程度呈正相关,这2项可以作为临床判断该病严重程度的指标,合理的护理措施对患儿的康复非常重要.%Objective To discuss the content of serum C-reactive protein and the glycoprotein KL- 6 in hand-foot and mouth disease complicated with neurogenic pulmonary edema children,and discuss related nursing measures,in order to provide the basis for diagnosis of hand-foot and mouth disease complicated with neurogenic pulmonary edema. Methods 96 cases of children patients with hand- foot and mouth disease complicated with neurogenic pulmonary edema from January 2010 to June 2011 were selected at random in our hospital,56 cases were heavy patients,40 patients were common type.Another 48 cases were randomly selected healthy volunteers.Using the turbidity to determine the content of C-reactive protein in serum,the Elisa method to determine the

  2. Swallowing function training combined with neuromuscular electrical stimulation treatment the neurogenic swallowing dysfunction%功能训练结合神经肌肉电刺激治疗脑卒中后神经源性吞咽功能障碍

    Institute of Scientific and Technical Information of China (English)

    辜敏

    2015-01-01

    目的:观察吞咽功能训练结合神经肌肉电刺激治疗脑卒中后神经源性吞咽功能障碍的疗效。方法临床纳入脑卒中后神经源性吞咽功能障碍患者76例,根据入院后治疗方案的不同分为研究组与对照组。研究组给予吞咽功能训练结合神经肌肉电刺激治疗,对照组仅给予神经肌肉电刺激治疗。观察察两组患者治愈率、吞咽造影检查(VFSS)、洼田氏饮水试验,并进行心理状态量评分调查。结果观察组临床治愈率68.42%,显著高于对照组的42.11%( P <0.05)。两组患者治疗后洼田氏饮水试验的分级较治疗前均有一定程度的好转,且研究组改善程度优于对照组( P <0.05)。研究组治疗后 VFSS 评分明显高于对照组( P <0.05)。观察组患者焦虑自评量表( SAS)、抑郁自评量表(SDS)、自尊量表(SES)平均得分均显著低于对照组,差异有显著性( P <0.05)。结论吞咽功能训练结合神经肌肉电刺激治疗脑卒中后神经源性吞咽功能障碍,具有较好的临床疗效,能够显著改善患者的吞咽障碍,同时可以明显缓解患者的负面情绪。%Objective To observe the treatment effect of swallowing function training combined with neuromuscular electrical stimulation to the neurogenic swallowing dysfunction after stroke. Methods Seventy - six patients who occurred neurogenic swallowing dysfunction in clinical were selected. According to the treatment after admission,they were divided into the study group and control group. The research group were trea-ted by swallowing function training combined with neuromuscular electrical stimulation therapy,while the control group were only given the neuro-muscular electrical stimulation therapy. The patients cure rate,swallowing angiography( VFSS),Watian drinking water test and mental status score of investigation were observed. Results The clinical cure rate of research group

  3. The effect of Danqi-Suoniao decoction combined with routine western medicine on urodynamics of diabetic neurogenic bladder%丹芪缩尿方结合西医常规疗法对糖尿病神经源性膀胱尿流动力学的影响

    Institute of Scientific and Technical Information of China (English)

    刘丽娟; 李辉; 张会凯

    2015-01-01

    Objective Observe the effect of Danqi-Suoniao decoction combined with conventional western medicine on urodynamics of diabetic neurogenic bladder. Methods 34 cases of the patients with diabetic neurogenic bladder were divided into a control group and an observation group,with 17 cases in each group. Both groups were treated control diet,proper exercise and bladder training. On this basis, the control blood was treated with insulin, and the observation group was additionally added Danqi Suoniao Fang on the basis of the control group. After 12 weeks of treatment,the difference of urodynamics,glycosylated hemoglobin, urine albumin excretion rate lipids in blood and blood pressure were observed. Results After 12 weeks of treatment,the residual urine volume (100.71 ± 28.37 ml vs. 130.24 ± 44.56 ml, t=2.719), the beginning of the bladder to urinate capacity (136.57 ± 19.42 ml vs. 150.65 ± 17.65 ml, t=2.334), the biggest urinate capacity (458.48 ± 107.80 ml vs. 520.73 ± 112.47 ml, t=2.463) were significantly decreased in observation group than the control group(P0.05). Conclusion Danqi-Suoniao decoction is effective in treating diabetic neurogenic bladder on the basis of controlling blood glucose with western medicine.%目的:探讨丹芪缩尿方结合西医常规疗法对糖尿病神经源性膀胱患者尿流动力学的影响。方法将符合入选标准的糖尿病神经源性膀胱患者34例按随机数字表法分为2组各17例。对照组患者须控制饮食,适当运动并进行膀胱训练,根据病情给予相应的控制血糖、抗感染、导尿等治疗;观察组在对照组基础上加用丹芪缩尿方治疗。共治疗12周。观察2组患者治疗前后尿流动力学及糖化血红蛋白、尿白蛋白排泄率、血脂、血压的变化。结果治疗后,观察组残尿量[(100.71±28.37)ml 比(130.24±44.56)ml,t=2.719]、膀胱初尿意容量[(136.57±19.42)ml 比(150.65±17.65)ml,t=2.334]、最大尿意容量[(458.48±107

  4. Arthrocentesis as initial treatment for temporomandibular joint arthropathy : A randomized controlled trial

    NARCIS (Netherlands)

    Vos, L. M.; Huddleston Slater, J. J. R.; Stegenga, B.

    2014-01-01

    Objective: To determine the effectiveness of arthrocentesis compared to conservative treatment as initial treatment with regard to temporomandibular joint pain and mandibular movement. Patients and methods: In this randomized controlled trial, 80 patients with arthralgia of the TMJ (classified accor

  5. A unique case of phaeohyphomycosis subretinal abscess in a patient with arthropathy and lung pathology

    Directory of Open Access Journals (Sweden)

    Bryan J Matthews

    2013-01-01

    Full Text Available A 67-year-old former gold miner with rheumatoid arthritis, treated with steroids and methotrexate, presented to eye casualty with a painful right eye. Examination revealed an anterior uveitis and despite an initial response to topical steroids, the intraocular inflammation worsened with anterior and posterior uveitis development. Re-examination showed a white mass in the peripheral nasal retina initially suspected of being active Toxoplasmosis infection and anti-toxoplasmosis treatment commenced. After improvement and tapering of this treatment, the intraocular inflammation reoccurred. Cytopathological examination of a pars plana vitrectomy obtained vitreous sample that showed a non-diagnostic non-infectious chronic vitritis. The vitreoretinal surgeons elected to do a direct biopsy of the white subretinal mass in the peripheral nasal area. This revealed, quite unexpectedly, an abscess containing pigmented phaeohyphomycosis fungi. This case report documents the multidisciplinary approach that assisted in clinching a final diagnosis and the role of sub-retinal biopsy in this unprecedented scenario.

  6. Charcot Neuropathic Arthropathy of the Foot: A Literature Review and Single-Center Experience

    Science.gov (United States)

    Shaikh, Haroun Hassan

    2016-01-01

    Charcot neuropathic osteoarthropathy of the foot is a relatively common complication of diabetic neuropathy. Incorrect diagnosis and improper treatment often result in the extremity having to be amputated. This paper summarises the current view on the etiology, diagnostics, and treatment of diabetic Charcot neuropathic osteoarthropathy, with particular focus on preserving the extremity through surgical intervention from our own experiences. PMID:27656656

  7. A unique case of phaeohyphomycosis subretinal abscess in a patient with arthropathy and lung pathology

    Science.gov (United States)

    Matthews, Bryan J.; Partridge, David; Sheard, Richard M; Rennie, Ian G; Mudhar, Hardeep Singh

    2013-01-01

    A 67-year-old former gold miner with rheumatoid arthritis, treated with steroids and methotrexate, presented to eye casualty with a painful right eye. Examination revealed an anterior uveitis and despite an initial response to topical steroids, the intraocular inflammation worsened with anterior and posterior uveitis development. Re-examination showed a white mass in the peripheral nasal retina initially suspected of being active Toxoplasmosis infection and anti-toxoplasmosis treatment commenced. After improvement and tapering of this treatment, the intraocular inflammation reoccurred. Cytopathological examination of a pars plana vitrectomy obtained vitreous sample that showed a non-diagnostic non-infectious chronic vitritis. The vitreoretinal surgeons elected to do a direct biopsy of the white subretinal mass in the peripheral nasal area. This revealed, quite unexpectedly, an abscess containing pigmented phaeohyphomycosis fungi. This case report documents the multidisciplinary approach that assisted in clinching a final diagnosis and the role of sub-retinal biopsy in this unprecedented scenario. PMID:24413827

  8. Triple Valvulopathy and Jaccoud's Arthropathy: A Case Report and Literature Review

    Science.gov (United States)

    Alhaddad, Bassam

    2016-01-01

    Cardiac involvement is fairly common in patients with systemic lupus erythematosus (SLE). It may involve all layers of the heart and coronary arteries as well as the heart valves. We report an extremely rare presentation of valvulitis and valvular dysfunction associated with systemic lupus erythematosus. This is the first case of lupus valvulitis which required three mechanical prosthetic valve replacements with disease recurrence leading to a fatal outcome. This is, in our point of view, the consequence of aggressive natural history of the disease and perhaps late diagnosis and treatment of underlying SLE which was unsuccessful.

  9. Multicentric osteolysis with nodulosis and arthropathy (MONA) with cardiac malformation, mimicking polyarticular juvenile idiopathic arthritis

    DEFF Research Database (Denmark)

    Castberg, Filip Christian; Kjaergaard, Susanne; Mosig, Rebecca A;

    2013-01-01

    , subcutaneous fibrocollagenous nodules, carpal and tarsal osteolysis and interphalangeal joint erosions. We present the case of a 5-year-old boy with double outlet right ventricle, ventricular septal defect, coarctation of the aorta and MONA. Previously, a total of 24 cases of MONA have been reported of which...

  10. Hemophilic arthropathy of the elbow: prophylaxis, imaging, and the role of invasive management.

    Science.gov (United States)

    Dale, Timothy M; Saucedo, James M; Rodríguez-Merchán, E Carlos

    2015-10-01

    Hemophilia is an X-linked recessive deficiency of clotting factor VIII (hemophilia A) or IX (hemophilia B) that can result in hemarthrosis of various joints, including the elbow. Left unchecked, this can lead to progressive joint destruction and significant morbidity. Appropriate management of the elbow joint through prophylactic measures, accurate imaging, and timely intervention is essential. Replacing or supplementing deficient factor with a plasma-derived or recombinant factor concentrate can minimize bleeding episodes. Joints should be routinely monitored for damage. Plain films offer an inexpensive window into bone disease and joint space changes but lack soft tissue detail and may not detect early changes. Magnetic resonance imaging provides a high level of detail but may be limited by its cost and need for sedation in younger patients. Ultrasound may not achieve the same level of resolution as magnetic resonance imaging, but it is increasingly used as a convenient, effective, and relatively inexpensive alternative. Patients who experience hemarthrosis of the elbow with joint damage often require more invasive treatment. Radiosynovectomy and arthroscopic synovectomy are effective at minimizing pain and preventing future bleeding episodes, whereas extensive joint damage may necessitate total elbow replacement. PMID:26385390

  11. Synoviorthesis with colloidal /sup 32/P chromic phosphate for hemophilic arthropathy: clinical follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Rivard, G.E.; Girard, M.; Lamarre, C.; Jutras, M.; Danais, S.; Guay, J.P.; Belanger, R.D.

    1985-11-01

    Thirty-one synoviortheses were performed in 22 joints of 14 hemophilic patients (aged 12 to 28 years) with chronic synovitis and for whom conventional treatments were considered ineffective. Except for patients with inhibitors, conventional treatments included three to six months of adequate prophylactic therapy with the missing coagulation factors, intensive physiotherapy and, when indicated, antiinflammatory agents and orthosis. Colloidal /sup 32/P chromic phosphate was injected intraarticularly in doses of 1.0 mCi for knees and of 0.5 mCi for the other joints. Time of follow-up ranged from two to five years. Frequency and importance of bleeding decreased in all patients. Effect on range of motion was best in knees. In elbows, flexion-extension was improved in four cases, unchanged in five and decreased in one; pronation-supination was decreased in four cases. The results of 13 synoviortheses in four hemophilic patients with high titer factor VIII inhibitors were comparable to those in hemophiliacs with no inhibitors. However, in three of the four patients synoviorthesis had to be repeated after two to four years for recurrence of synovitis. Extraarticular escape of radioactivity was monitored 62 times for 17 synoviortheses in 12 patients; extraarticular counts never exceeded 4% of the intraarticular counts. Chromosome aberrations were found not to be increased after treatment in the seven patients in whom adequate analysis could be done.

  12. Neurogenic effects of fingolimod in hippocampus, affecting fear memory.

    Directory of Open Access Journals (Sweden)

    Paschalis Efstathopoulos

    2014-05-01

    Full Text Available Fingolimod (FTY720; Gilenya™,Novartis Pharma AG is a recently developed Sphingosine-1-Phosphate (S1P analogue, orally administered as a new therapeutic agent in Multiple Sclerosis (MS (Brinkmann V. et al. 2010. S1P receptors (S1PRs are expressed in various sites in the CNS including the subventricular zone (Waeber C. et al. 1999; Choi J.W. et al. 2013 while endogenous S1P was shown to induce proliferation and morphological changes in embryonic hippocampal neural progenitors in culture (Harada J. et al. 2004. In this study we investigated the effects of fingolimod on adult rodent hippocampal neurogenesis and their possible functional role. To this aim, thymidine analogue BrdU was injected at the end or before a 2-week i.p. administration of a therapeutic dose of Fingolimod (0,3 mg/kg in young and old mice. Stereological counts of BrdU+ cells revealed significant increase in both proliferation, and survival of neural stem cells (NSC in the area of Dentate Gyrus (DG of the hippocampus, compared to control untreated animals of young but not old ages. In the case of survival assessment, most of the BrdU + cells were also positive for NeuN, suggesting an increase of newly formed neurons. The increase in proliferation rate of NSC was also confirmed by BrdU uptake in hippocampal NSC cultures in vitro, implying that the effects of fingolimod are cell autonomous. Immunohistochemical analysis showed that S1PR was not co-localized with GFAP+ cells in the Subgranular zone (SGZ of the DG, but was strongly co-localized with transcription factor MASH1 and weakly with DcX or PSA-NCAM positive neural progenitors. These findings suggest that expression of S1PR1 in the SGZ is restricted to transit amplifying neural progenitors and maintained also in the stage of neuroblast. In addition, the effects of Fingolimod in DG neurogenesis were positively correlated to enhanced fear memory and increased context discrimination, an established DG-dependent cognitive task (Saxa D. et al. 2006; Sahay A. et al. 2011. Conclusively, our data suggest that Fingolimod increases neurogenesis in adult hippocampus and improves memory function.

  13. [Chondropathia patellae--a sequel of a primary neurogenic lesion?].

    Science.gov (United States)

    Rüther, W; Vogel, P; Tackmann, W

    1987-01-01

    In twenty patients with a patellar pain syndrome (Chondropathia patellae) the quadriceps muscles were examined electromyographically. The study aimed for detection of neural lesions in the respective segments. According to Weh and Eickhoff (1983) nerve root lesions are the common cause for patellar pain syndrome. In their opinion malinnervation of the quadriceps leads to a muscular disbalance of the vastus medialis and lateralis and in consequence to an unphysiological traction of their patellar insertions that induces pain. Neither clinical data nor electromyographical findings gave any indication to believe that primary nerve root disturbances are a common cause for patellar pain syndrome.

  14. The role of MRI in screening for neurogenic hypertension

    International Nuclear Information System (INIS)

    Neurovascular compression (NVC) of the left ventrolateral medulla (VLM) has been implicated as a cause of essential hypertension. We investigated whether high-resolution MRI of the posterior cranial fossa could identify patients with essential hypertension who may benefit from surgery. A retrospective analysis of imaging and clinical records from 162 patients was performed. There were 38 patients with essential hypertension and 124 who were normotensive. Contact or compression of the VLM was present in 42.1 % (16/38) of the hypertensive group on the left and 47.3 % (18/38) on the right. In the normotensive group it was seen in 32.2 % (40/124) on the left and 26.6 % (33/124) on the right. There was no significant difference between the hypertensive and control groups with regard to contact or compression of the left VLM. The results support the contention that neurovascular compression (NVC) of the left or right VLM is a common finding on MRI in normotensive individuals. We therefore believe that high-resolution MRI cannot be used as a screening tool to identify patients who may benefit from surgery. (orig.)

  15. Treatment of the neurogenic bladder in spina bifida

    OpenAIRE

    Tom P V M de Jong; Chrzan, Rafal; Klijn, Aart J.; Dik, Pieter

    2008-01-01

    Renal damage and renal failure are among the most severe complications of spina bifida. Over the past decades, a comprehensive treatment strategy has been applied that results in minimal renal scaring. In addition, the majority of patients can be dry for urine by the time they go to primary school. To obtain such results, it is mandatory to treat detrusor overactivity from birth onward, as upper urinary tract changes predominantly start in the first months of life. This means that new patient...

  16. Capsaicin-induced neurogenic inflammation in pig skin

    DEFF Research Database (Denmark)

    Di Giminiani, Pierpaolo; Petersen, Lars J; Herskin, Mette S

    2014-01-01

    Topical capsaicin is a well-established model of experimental hyperalgesia. Its application to the study of animals has been limited to few species. The effect of topical capsaicin on hyperalgesia in porcine skin was evaluated as part of a study of inflammatory pain in the pig. Two experiments we...

  17. Medical image of the week: neurogenic pulmonary edema

    Directory of Open Access Journals (Sweden)

    Yun S

    2014-02-01

    Full Text Available No abstract available. Article truncated at 150 words. A 79 year old woman with a history of diabetes, hypertension and subarachnoid hemorrhage presented to the emergency department (ED with altered mental status. The patient had a fall one day prior to admission, and hit her head on the ground. There was no loss of consciousness or seizure activity at that moment, however, she was found unresponsive in the bathroom the next day with brownish vomitus in the mouth and on her face. CT of the head without contrast showed a large intraparenchymal hemorrhage on the left frontal lobe with subdural hemorrhage on the right frontal and temporal lobe. Also, intraventricular blood with 1.1 cm left to right midline shift was observed (Figure 1. Although she had no history of left heart failure or pulmonary disease, physical exam showed coarse lung sound and chest X-ray showed acute change with prominence central vasculature with fluffy central airspace opacities, which were …

  18. Does Race/Ethnicity Really Matter in Adult Neurogenics?

    Science.gov (United States)

    Ellis, Charles

    2009-01-01

    Purpose: Recent evidence suggests that race/ethnicity is a variable that is critical to outcomes in neurological disorders. The purpose of this article was to examine the proportion of studies published in the "American Journal of Speech-Language Pathology (AJSLP)" and the "Journal of Speech, Language, and Hearing Research (JSLHR)" that were…

  19. Exosomes as Novel Regulators of Adult Neurogenic Niches

    OpenAIRE

    Bátiz, Luis Federico; Castro, Maite A.; Burgos, Patricia V.; Velásquez, Zahady D.; Muñoz, Rosa I.; Lafourcade, Carlos A.; Troncoso-Escudero, Paulina; Wyneken, Ursula

    2016-01-01

    Adult neurogenesis has been convincingly demonstrated in two regions of the mammalian brain: the sub-granular zone (SGZ) of the dentate gyrus (DG) in the hippocampus, and the sub-ventricular zone (SVZ) of the lateral ventricles (LV). SGZ newborn neurons are destined to the granular cell layer (GCL) of the DG, while new neurons from the SVZ neurons migrate rostrally into the olfactory bulb (OB). The process of adult neurogenesis persists throughout life and is supported by a pool of neural ste...

  20. Clinical features and emergency management of severe encephalitis and neurogenic pulmonary edema caused by enterovirus type 71 in children%儿童危重肠道病毒71型脑炎及神经源性肺水肿的临床特征与救治

    Institute of Scientific and Technical Information of China (English)

    张育才; 李兴旺; 朱晓东; 钱素云; 曾健生; 尚云晓; 李璧如; 刘晓琳; 冉献贵

    2008-01-01

    目的 探讨儿童重症手足口病合并中枢神经系统感染及神经源性肺水肿(NPE)的临床特征、救治经验和转归.方法 总结2008年5月至6月收入安徽省阜阳市级医院儿童重症监护病房(PICU)手足口病合并巾枢神经系统感染及NPE救治资料.结果 36例患儿中,平均年龄15.8个月(4月至4岁),死亡7例,病死率为19.4%.出现危重症状平均病程2.1 d(0.5~5.0 d).12例(33.3%)无皮疹.神经系统表现为脑干脑炎27例(75%)、脑干脑炎伴脊髓炎6例(16.7%)、腩炎3例(8.3%).NPE突出表现是突然呼吸急促、粉红色或血性泡沫液(痰)、非对称性肺水肿或肺出血,是最直接死亡原因.主要救治措施为机械通气、甘露醇、甲基强的松龙、静脉丙种球蛋白、血管活性药物,其中9例患儿(25%)进行容量复苏.结论 EV71脑炎合并NPE,发病年龄小,进展快,病死率较高.早期诊断、及时呼吸支持、积极降颅压、维护循环功能是救治成功的关键.%Objective To investigate the clinical characteristics and emergency management of severe hand-foot-mouth disease(HFMD)associated with encephalitis and neurogenic pulmonary edema(NPE)caused by en-terovirus 71(EV71)in children.Method Data of critical patients with severe HFMD associated with encephalitis and NPE admitted to pediatric intensive care unit(PICU)Fuyan city Hospitals Anhni Province from May to June 2008 were reviewed.Results Of 30 patients,the mean age was 15.8 months ranged from 4 months to 48 months.The overall morality was 19.4%.Tha average duration of critical symptoms persisted Was 2.1 days ranged from 12 hours to 5 days.There were no rash found in 12 patients(33.3%).The chinical features of nervous system mani-fested the symptoms of brainstem encephalitis in 27 patients(75%),brainstem encephalitis with myelitis in 6 pa-tients(16.7%),and encephalitis in 3 patients(8.3%).The frothy expectoration tinged with pink or bloody,asyrmmetrical pulmonary edema or hemoptysis

  1. The study of the colonic motility and anorectal function in patients with neurogenic bowel induced by myelodysplasia%脊髓发育不良致神经源性肛肠的结肠动力与肛直肠功能研究

    Institute of Scientific and Technical Information of China (English)

    孙大庆; 张文同; 张帆; 李爱武; 张蕾; 李殿国; 韩克; 陈维秀; 孙小兵; 李金良

    2008-01-01

    目的 探讨脊髓发育不良致神经源性肛肠的结肠动力与肛直肠功能.方法 42例神经源性肛肠患儿,男22例,女20例,平均年龄7.8岁.无肛肠及神经疾病患儿34例作为正常对照组,其中男19例,女15例,平均年龄7.6岁.结肠传输试验采用连续6 d每天同一时间口服不透X线标记物追踪法测定传输时间,肛直肠测压采用高分辨多通道胃肠功能测定仪对代表直肠肌力、感觉和肛直肠反射多项指标测量.结果 全结肠通过时间(TCTT)病变组为(67.5±7.2)h,明显高于正常对照组(36.6±6.8)h(P<0.05).分段结肠通过时间中,左半结肠(LCTT)和乙状结肠(SCTT)的实验组与对照组之间均有显著性差异,右半结肠通过时间(RCTT)的实验组与对照组之间无统计学意义.直肠感觉阈、肛管收缩向量容积、静息向量容积及直肠肛门抑制反射指标二组间均存在明显差异.结论 脊髓发育不良致神经源性肛肠不仅结肠动力出现障碍,肛直肠感觉运动功能都受到不同程度损害,临床应综合评定其功能,制定合理治疗方案.%Objective To evaluate the colonic motility and anorectat function in patients with neurogenic bowel induced by myelodysplasia. Methods Forty-two children with myelodysplasia (22 males and 20 females with the mean age of 7.8 years) and 34 healthy children (19 males and 15 females with the mean age of 7.6 years) underwent measurement of colonic transit time and anorectal manometry. Radiopaque markers were ingested daily for 6 days and followed by administration of a single abdominal x-ray on day 7. Colonic transit time was calculated by dividing the number of retained markers in the whole, right, left, or sigmoid colon. Multichannel anorectal function detector was applied in the measurement of sensation threshold, rectal-anal inhibitory reflex and anorectal vector volume. Results Total colonic transmission time (TCTT) was significantly prolonged in patients with myelodysplasia

  2. 重症手足口病患儿血清炎性细胞因子动态变化与神经源性肺水肿的关系%Dynamic changes in serum inflammatory cytokines and their association with neurogenic pulmonary edema in patients with severe hand-foot-mouth disease

    Institute of Scientific and Technical Information of China (English)

    冯慧芬; 段广才; 朱光

    2015-01-01

    目的 探讨重症手足口病(HFMD)患儿血清炎性细胞因子动态变化及其与神经源性肺水肿(NPE)的关系.方法 选择2010年3月至2012年12月89例住院重症HFMD患者,按其是否发生NPE分为神经系统受累组(CNSD)与NPE组,于入院后第1、3和5天采用酶链免疫吸附法检测血清IL-4、IL-10、IL-6、IL-17、肿瘤坏死因子-α(TNF-α)、干扰素-γ(IFN-γ)水平,多因素Logistic回归分析筛选NPE的危险因素.结果 1.NPE组IL-6(F时间=1.876,P=0.177;F交互 =2.192,P=0.145;F组间=7.855,P=0.007)、TNF-α(F时间=13.133,P=0.001;F交互 =0.291,P=0.592;F组间=3.644,P=0.042)、IL-10(F时间=14.580,P=0.001;F交互=2.612,P=0.078;F组间=16.823,P=0.000)、INF-γ(F时间=3.093,P=0.045;F交互=0.513,P=0.600;F组间=20.141,P=0.000)水平显著高于CNSD组.2.TNF-α、IL-10、INF-γ于入院第3天达到高峰.3.年龄(OR=3.383,95% CI:1.173 ~4.759)、持续发热(OR=4.925,95% CI:1.758 ~3.794)、血糖(OR=3.465,95% CI:1.303 ~5.220)、白细胞计数(OR=7.579,95% CI:2.530 ~ 12.704)及IL-10(OR=1.228,95% CI:1.007 ~1.523)是重症HFMD发生NPE的危险因素.结论 炎性细胞因子的动态失衡与NPE的发生、发展有关,并可用于评估重症HFMD发生NPE的风险.%Objective To investigate the dynamic changes in the serum inflammatory cytokines and their association with neurogenic pulmonary edema (NPE) in the patients with severe hand-foot-mouth disease (HFMD).Methods Eighty-nine patients with severe HFMD from March 2010 to December 2012 were recruited in the study.The patients were divided into NPE group and central nervous system diseases (CNSD) group according whether they had NPE.The cytokines,including interleukin (IL)-4,IL-6,IL-10,IL-17,tumor necrosis factor-α (TNF-α) and interferon-γ(IFN-γ)were evaluated by using enzyme-linked immunosorbent assay on day 1,3 and 5 after admission to hospital.Risk factors for NPE involvement during hospital stay were analyzed with multivariate Logistic

  3. O cuidar de crianças portadoras de bexiga neurogênica: representações sociais das necessidades dessas crianças e suas mães El cuidar niños portadores de vejiga neurogenica: representaciones sociales de las necesidades de esos niños y sus madres Caring for children with neurogenic blader dysfunction: social representation of these children's and their mothers' needs

    Directory of Open Access Journals (Sweden)

    Maria de Fátima Farinha Martins Furlan

    2003-12-01

    Full Text Available Esta investigação buscou conhecer e analisar as representações e necessidades de crianças em idade escolar, portadoras de bexiga neurogênica, e de suas mães. A pesquisa foi de natureza qualitativa, sendo as representações sociais o processo metodológico adotado. Na interposição das categorias empíricas com as analíticas, o viver e o cuidar são representados respectivamente pelas mães como um "problema" e "tudo eu"; as crianças, por sua vez, interpretam com "num é justo" a interação diferenciada e preconceituosa que sofrem no contexto em que estão inseridas.Esta investigación busca conocer y analizar las representaciones y necesidades de niños en edad escolar, portadores de vejiga neurogénica y sus madres. Investigación de naturaleza cualitativa, siendo las representaciones sociales el proceso metodológico adoptado. La interposición de las categorías empíricas con las analíticas, el vivir y el cuidar son representados respectivamente por las madres como un "problema" y "todo yo"; los niños, a su vez, interpretan como "no es justa" la interacción diferenciada y con preconceptos que sufren en el contexto en el cual estos niños se desenvuelven cotidianamente.The purpose of this study was to know and analyze the representations and needs of school-age children with neurogenic bladder dysfunction and of their mothers. This is a qualitative study; whose methodology was based on social representations. According to the interposition of empirical end analytical categories, the living and caring are respectively represented by mothers as "a problem" and "all me"; the children, in turn, interpret the differentiated and prejudiced interaction they suffer in the setting they live in as "it is not fair".

  4. MDCT assessment of CAD in type-2 diabetic subjects with diabetic neuropathy: the role of Charcot neuro-arthropathy

    International Nuclear Information System (INIS)

    To compare the CACS and CAD severity assessed by MDCT in neuropathic type-2 diabetic patients with and without Charcot-neuroarthropathy (CN). Thirty-four CN asymptomatic-patients and 36 asymptomatic-patients with diabetic-neuropathy (DN) without CN underwent MDCT to assess CACS and severity of CAD. Patients were classified as positive for significant CAD in presence of at least one stenosis >50 % on MDCT-coronary-angiography (MDCT-CA). Groups were matched for age, sex and traditional CAD risk-factors. The coronary-angiography (CA) was performed in all patients with at least a significant stenosis detected by MDCT-CA, both as reference and eventually as treatment. CN patients showed higher rates of significant CAD in comparison with DN subjects [p < 0.001], while non-significant differences were observed in CACS (p = 0.980). No significant differences were also observed in CACS distribution in all subjects for stenosis ≥/<50 % (p = 0.814), as well as in both groups (p = 0.661 and 0.559, respectively). The MDCT-CA showed an overall diagnostic-accuracy for significant CAD of 87 %. These preliminary data suggest that CN-patients have a higher prevalence of severe CAD in comparison with DN-patients, while coronary plaques do not exhibit an increased amount of calcium. MDCT may be helpful to assess the CV risk in such asymptomatic type-2-diabetic patients with autonomic-neuropathy. (orig.)

  5. MDCT assessment of CAD in type-2 diabetic subjects with diabetic neuropathy: the role of Charcot neuro-arthropathy

    Energy Technology Data Exchange (ETDEWEB)

    Marano, Riccardo; Savino, Giancarlo; Merlino, Biagio; Pirro, Federica; Rutigliano, Claudia; Santangelo, Carolina; Minoiu, Aurelian Costin; Natale, Luigi; Bonomo, Lorenzo [Catholic University of Rome, ' ' A. Gemelli' ' University Hospital, Department of Radiological Sciences - Institute of Radiology, Rome (Italy); Pitocco, Dario [Catholic University of Rome, ' ' A. Gemelli' ' University Hospital, Department of Internal Medicine, Rome (Italy); Di Stasio, Enrico [Catholic University of Rome, ' ' A. Gemelli' ' University Hospital, Department of Clinical Biochemistry, Rome (Italy); Trani, Carlo [Catholic University of Rome, ' ' A. Gemelli' ' University Hospital, Department of Cardiovascular Medicine - Institute of Cardiology, Rome (Italy)

    2016-03-15

    To compare the CACS and CAD severity assessed by MDCT in neuropathic type-2 diabetic patients with and without Charcot-neuroarthropathy (CN). Thirty-four CN asymptomatic-patients and 36 asymptomatic-patients with diabetic-neuropathy (DN) without CN underwent MDCT to assess CACS and severity of CAD. Patients were classified as positive for significant CAD in presence of at least one stenosis >50 % on MDCT-coronary-angiography (MDCT-CA). Groups were matched for age, sex and traditional CAD risk-factors. The coronary-angiography (CA) was performed in all patients with at least a significant stenosis detected by MDCT-CA, both as reference and eventually as treatment. CN patients showed higher rates of significant CAD in comparison with DN subjects [p < 0.001], while non-significant differences were observed in CACS (p = 0.980). No significant differences were also observed in CACS distribution in all subjects for stenosis ≥/<50 % (p = 0.814), as well as in both groups (p = 0.661 and 0.559, respectively). The MDCT-CA showed an overall diagnostic-accuracy for significant CAD of 87 %. These preliminary data suggest that CN-patients have a higher prevalence of severe CAD in comparison with DN-patients, while coronary plaques do not exhibit an increased amount of calcium. MDCT may be helpful to assess the CV risk in such asymptomatic type-2-diabetic patients with autonomic-neuropathy. (orig.)

  6. Reactive Arthritis Secondary to Cauda Equina Injury following Spine Fracture: A Case Report

    Directory of Open Access Journals (Sweden)

    Xiao Li

    2011-01-01

    Full Text Available A 38-year-old man presented with a one-month history of muscle weakness and dysesthesia in the lower extremities, urinary retention, and urinary tract infection after lumbar burst fracture resulted from high fall. During the rehabilitation in our hospital, he had arthritis in both the ankle and knee. However, the patient was treated as gouty arthropathy initially. The arthritis was completely remitted in a few days after the patient was diagnosed as reactive arthritis and started with sulfasalazine therapy and there was no recurrence during 4 months of follow-up. Based on this case, early recognition of reactive arthritis is of major importance to avoid delayed initiation of appropriate treatment in the patients with polyarthritis secondary to neurogenic bladder following cauda equina injury after spine fracture.

  7. NEUROBLASTOMA;VARIABLE SYMPTOMS OF A NEUROGENIC TUMOR; A REPORT FROM IRAN

    Directory of Open Access Journals (Sweden)

    M. T. Arzanian

    2008-10-01

    Full Text Available ObjectiveAccording to current data available, neuroblastoma is the most frequent extracranial solid tumor in infants and children; because of its relationship to the primitive sympathetic ganglia, it may progress or regress spontaneously to more malignant or benign forms of tumors, respectively. It is also an important cause of the Opsoclonus Myoclonus Ataxia Syndrome (OMAS, or the "dancing eyes"syndrome. The risk factor of neuroblastoma includes patient's age at diagnosis; degree of tumor spread, and selected biologic variables such as serum LDH, urinary and serum catecholamines such as VMA and HVA, ploidy and MYCN copy numbers. So, detection of risk factors and risk directed therapy are the mainstay of patient management.Materials & MethodsFor this study the records of 43 out of 46 patients, aged less than 14 years, admitted over 8 years (1996-2004, with the confirmed diagnosis of neuroblastoma or ganglioneuroblastoma were evaluated for full course of therapy and follow up.ResultsOf the patient group, 60% were male and 40% female. The most frequent clinical stage was stage 3 (34.7%, followed with stage 4 (32.6% and 2 (26%.Less than 2% of patients presented with pure neurologic symptoms and these responded well to treatment. Relapse was seen more frequently in stage 4 patients and less in stage 4S. The OPEC protocol, started in 81% of patients, achieved a 54% response; on the other hand, in 15%, N6 was used, with the response rate of 40%. Patient data was analyzed and interpreted using SPSS software to reveal which clinical and biologic factors improve neuroblastoma outcome.ConclusionStaging and patients' age at the time of diagnosis are the most important clinical factors to predict outcome, while primary tumor site and some biologic findings such as urinary VMA and serum LDH levels have a less important value.

  8. A step-wise approach to sperm retrieval in men with neurogenic anejaculation

    DEFF Research Database (Denmark)

    Fode, Mikkel; Ohl, Dana A; Sønksen, Jens

    2015-01-01

    is most commonly associated with spinal cord injury. This aetiology is especially relevant because most men with spinal cord injuries are injured at reproductive age. Assisted ejaculation in the form of penile vibratory stimulation is the first choice for sperm retrieval in such patients because...

  9. Immunoreactivity of neurogenic factor in the guinea pig brain after prenatal hypoxia.

    Science.gov (United States)

    Chung, Yoonyoung; So, Keumyoung; Kim, Eunyoung; Kim, Seokwon; Jeon, Yonghyun

    2015-07-01

    Chronic prenatal hypoxia is considered to cause perinatal brain injury. It can result in neurological disorders such as cerebral palsy or learning disabilities. These neurological problems are related to chronic placental insufficiency (CPI), which leads to chronic hypoxemia and hypoglycemia. The effects of hypoxia on neurogenesis during development have been a matter of controversy. We therefore investigated the effect of chronic prenatal hypoxia in the brain of the fetal guinea pig using the guinea pig CPI model. Chronic placental insufficiency was induced by unilateral uterine artery ligation at 30-32 days of gestation (dg: with term defined as ∼67dg). At 50 and 60dg, fetuses were sacrificed and assigned to either the growth-restricted (GR) or control (no ligation) group. Immunohistochemistry was performed with HIF-1α, PCNA, NeuN and BDNF antibodies in the cerebral cortex and dentate gyrus. The number of NeuN-IR and BDNF-IR cells was lesser in GR fetuses than in controls in the cerebral cortex and dentate gyrus at 60dg (pcerebral cortex is decreased by chronic prenatal hypoxia at 60dg.

  10. Histaminergic nerves demonstrated in the skin. A new direct mode of neurogenic inflammation?

    Science.gov (United States)

    Johansson, O; Virtanen, M; Hilliges, M

    1995-04-01

    An intradermal administration of histamine into human skin results in a local erythema, edema and often also the sensations of itch and/or pain. These effects have classically been attributed to the presence of histamine-containing mast cells. However, in the present investigation, we report the observation of histamine-immunoreactive nerves in the skin of Sprague-Dawley rats using a new and highly sensitive immunohistochemical approach. These data suggest a more direct route of cutaneous histamine effects, mediated exclusively by the peripheral nervous system. The findings could also give a new basis for explaining histamine-related issues, such as itch. PMID:7543795

  11. Time-Dependent Effect of Encapsulating Alginate Hydrogel on Neurogenic Potential

    Science.gov (United States)

    Razavi, Shahnaz; Khosravizadeh, Zahra; Bahramian, Hamid; Kazemi, Mohammad

    2015-01-01

    Objective Due to the restricted potential of neural stem cells for regeneration of central nervous system (CNS) after injury, providing an alternative source for neural stem cells is essential. Adipose derived stem cells (ADSCs) are multipotent cells with properties suitable for tissue engineering. In addition, alginate hydrogel is a biocompatible polysaccharide polymer that has been used to encapsulate many types of cells. The aim of this study was to assess the proliferation rate and level of expression of neural markers; NESTIN, glial fibrillary acidic protein (GFAP) and microtubule-associated protein 2 (MAP2) in encapsulated human ADSCs (hADSCs) 10 and14 days after neural induction. Materials and Methods In this experimental study, ADSCs isolated from human were cultured in neural induction media and seeded into alginate hydrogel. The rate of proliferation and differentiation of encapsulated cells were evaluated by 3-[4, 5-dimethylthiazol-2-yl]-2, 5-diphenyl tetrazolium bromide (MTT) assay, immunocytoflourescent and realtime reverse transcriptase polymerase chain reaction (RT-PCR) analyzes 10 and 14 days after induction. Results The rate of proliferation of encapsulated cells was not significantly changed with time passage. The expression of NESTIN and GFAP significantly decreased on day 14 relative to day 10 (P<0.001) but MAP2 expression was increased. Conclusion Alginate hydrogel can promote the neural differentiation of encapsulated hADSCs with time passage. PMID:26199909

  12. NEUROBLASTOMA;VARIABLE SYMPTOMS OF A NEUROGENIC TUMOR; A REPORT FROM IRAN

    Directory of Open Access Journals (Sweden)

    M. T. Arzanian

    2009-01-01

    Full Text Available ObjectiveAccording to current data available, neuroblastoma is the most frequent extracranial solid tumor in infants and children; because of its relationship to the primitive sympathetic ganglia, it may progress or regress spontaneously to more malignant or benign forms of tumors, respectively. It is also an important cause of the Opsoclonus Myoclonus Ataxia Syndrome (OMAS, or the "dancing eyes"syndrome. The risk factor of neuroblastoma includes patient's age at diagnosis; degree of tumor spread, and selected biologic variables such as serum LDH, urinary and serum catecholamines such as VMA and HVA, ploidy and MYCN copy numbers. So, detection of risk factors and risk directed therapy are the mainstay of patient management.Materials & MethodsFor this study the records of 43 out of 46 patients, aged less than 14 years, admitted over 8 years (1996-2004, with the confirmed diagnosis of neuroblastoma or ganglioneuroblastoma were evaluated for full course of therapy and follow up.ResultsOf the patient group, 60% were male and 40% female. The most frequent clinical stage was stage 3 (34.7%, followed with stage 4 (32.6% and 2 (26%.Less than 2% of patients presented with pure neurologic symptoms and these responded well to treatment. Relapse was seen more frequently in stage 4 patients and less in stage 4S. The OPEC protocol, started in 81% of patients, achieved a 54% response; on the other hand, in 15%, N6 was used, with the response rate of 40%. Patient data was analyzed and interpreted using SPSS software to reveal which clinical and biologic factors improve neuroblastoma outcome.ConclusionStaging and patients' age at the time of diagnosis are the most important clinical factors to predict outcome, while primary tumor site and some biologic findings such as urinary VMA and serum LDH levels have a less important value .Keywords: Neuroblastoma, Malignancy, Chemotherapy, Prognosis, Adrenal, Children, Opsoclonus myoclonus

  13. Dynamic expression of Notch-dependent neurogenic markers in the chick embryonic nervous system

    Directory of Open Access Journals (Sweden)

    Leslie eRatié

    2014-12-01

    Full Text Available The establishment of a functional nervous system requires a highly orchestrated process of neural proliferation and differentiation. The evolutionary conserved Notch signalling pathway is a key regulator of this process, regulating bHLH transcriptional repressors and proneural genes. However little is known about downstream Notch targets and subsequently genes required for neuronal specification.In this report, the expression pattern of Tagln3, Chga and Cntn2 was described in detail during early chick embryogenesis. Expression of these genes was largely restricted to the nervous system including the early axon scaffold populations, cranial ganglia and spinal motor neurons. Their temporal and spatial expression were compared with the neuronal markers Nhlh1, Stmn2 and HuC/D. We show that Tagln3 is an early marker for postmitotic neurons whereas Chga and Cntn2 are expressed in mature neurons. We demonstrate that inhibition of Notch signalling during spinal cord neurogenesis enhances expression of these markers. This data demonstrates that Tagln3, Chga and Cntn2 represent strong new candidates to contribute to the sequential progression of vertebrate neurogenesis.

  14. Effect of 5-hydroxytryptamine on neurogenic vasoconstriction in the isolated, autoperfused hindquarters of the rat.

    Science.gov (United States)

    Calama, E; Ortíz de Urbina, A V; Morán, A; Martín, M L; San Román, L

    2005-10-01

    1. In the present study, we analysed the effect of different doses of 5-hydroxytryptamine (5-HT; intravenous infusions of 0.001-40 microg/kg per min) in the autoperfused hindquarters of the rat subjected to electrical stimulation (frequencies of 0.5-20 Hz) of the lumbar chains, investigating the relationship between the adrenergic and serotonergic systems in this vascular bed. 2. Because we observed that 5-HT inhibited the increases in perfusion pressure induced by electrical stimulation of the lumbar chains, we used different agonists and antagonists to analyse the mechanism of action of 5-HT. 3. The effect of 5-HT was inhibited by methiothepin (a non-specific 5-HT receptor antagonist), but not by ritanserin (a selective 5-HT2 receptor antagonist). The effects of 5-HT were mimicked by 5-carboxamidotryptamine (a 5-HT1 receptor agonist) and L-694 247 (a selective 5-HT1D receptor agonist), but not by 8-hydroxy-2-dipropylaminotetralin (a 5-HT1A receptor agonist), CGS-12066B (a 5-HT1B receptor agonist), alpha-methyl-5-HT (a 5-HT2 receptor agonist), 1-(3-chlorophenyl) piperazine (a 5-HT2C receptor agonist) or 1-phenylbiguanide (a 5-HT3 receptor agonist). The selective 5-HT1D/1B receptor antagonist BRL 15572 inhibited the effect of the agonist L-694 247. 4. Our data suggest that 5-HT inhibits the increases in perfusion pressure induced by the electrical stimulation of the lumbar chains, acting on presynaptic 5-HT1D receptors and decreasing the release of noradrenaline from the sympathetic nerves in the hindquarter vascular bed of the rat.

  15. Global expression profiling of globose basal cells and neurogenic progression within the olfactory epithelium.

    Science.gov (United States)

    Krolewski, Richard C; Packard, Adam; Schwob, James E

    2013-03-01

    Ongoing, lifelong neurogenesis maintains the neuronal population of the olfactory epithelium in the face of piecemeal neuronal turnover and restores it following wholesale loss. The molecular phenotypes corresponding to different stages along the progression from multipotent globose basal cell (GBC) progenitor to differentiated olfactory sensory neuron are poorly characterized. We used the transgenic expression of enhanced green fluorescent protein (eGFP) and cell surface markers to FACS-isolate ΔSox2-eGFP(+) GBCs, Neurog1-eGFP(+) GBCs and immature neurons, and ΔOMP-eGFP(+) mature neurons from normal adult mice. In addition, the latter two populations were also collected 3 weeks after olfactory bulb ablation, a lesion that results in persistently elevated neurogenesis. Global profiling of mRNA from the populations indicates that all stages of neurogenesis share a cohort of >2,100 genes that are upregulated compared to sustentacular cells. A further cohort of >1,200 genes are specifically upregulated in GBCs as compared to sustentacular cells and differentiated neurons. The increased rate of neurogenesis caused by olfactory bulbectomy had little effect on the transcriptional profile of the Neurog1-eGFP(+) population. In contrast, the abbreviated lifespan of ΔOMP-eGFP(+) neurons born in the absence of the bulb correlated with substantial differences in gene expression as compared to the mature neurons of the normal epithelium. Detailed examination of the specific genes upregulated in the different progenitor populations revealed that the chromatin modifying complex proteins LSD1 and coREST were expressed sequentially in upstream ΔSox2-eGFP(+) GBCs and Neurog1-eGFP(+) GBCs/immature neurons. The expression patterns of these proteins are dynamically regulated after activation of the epithelium by methyl bromide lesion.

  16. Recurrent spontaneous hypoglycaemia causes loss of neurogenic and neuroglycopaenic signs in infants with Congenital Hyperinsulinism

    DEFF Research Database (Denmark)

    Christesen, Henrik Thybo; Brusgaard, Klaus; Hussain, Khalid

    ). Methods: The autonomic, neuroglycopaenic, and glucose counter-regulatory hormonal responses were assessed in a) seven infants with CHI during a controlled fast following initial symptomatic hypoglycaemia and three recent episodes of spontaneous recurrent hypoglycaemia each lasting less than 5 minutes......; and in b) seven infants with ketotic hypoglycaemia for control. Results: When repeated hypoglycaemia was provoked, all CHI patients exhibited a complete loss of hypoglycaemic symptoms and signs, along with a global blunting of the counter-regulatory cortisol, glucagon, growth hormone, epinephrine and nor....../L, respectively). Conclusions: Recurrent hyperinsulinaemic hypoglycaemia even of short duration blunts the autonomic, neuroglycopaenic, and glucose counterregulatory hormonal responses in infants with CHI. Tight, or continuous, glucose monitoring is therefore recommended, especially in conservatively treated...

  17. Neurogenesis in sea urchin embryos and the diversity of deuterostome neurogenic mechanisms.

    Science.gov (United States)

    Garner, Sarah; Zysk, Ivona; Byrne, Glynis; Kramer, Marabeth; Moller, Daniel; Taylor, Valerie; Burke, Robert D

    2016-01-15

    A single origin to the diverse mechanisms of metazoan neurogenesis is suggested by the involvement of common signaling components and similar classes of transcription factors. However, in many forms we lack details of where neurons arise, patterns of cell division, and specific differentiation pathway components. The sea urchin larval nervous system is composed of an apical organ, which develops from neuroepithelium and functions as a central nervous system, and peripheral neurons, which differentiate in the ciliary band and project axons to the apical organ. To reveal developmental mechanisms of neurogenesis in this basal deuterostome, we developed antibodies to SoxC, SoxB2, ELAV and Brn1/2/4 and used neurons that develop at specific locations to establish a timeline for neurogenesis. Neural progenitors express, in turn, SoxB2, SoxC, and Brn1/2/4, before projecting neurites and expressing ELAV and SynB. Using pulse-chase labeling of cells with a thymidine analog to identify cells in S-phase, we establish that neurons identified by location are in their last mitotic cycle at the time of hatching, and S-phase is coincident with expression of SoxC. The number of cells expressing SoxC and differentiating as neurons is reduced in embryos injected with antisense morpholino oligonucleotides to SoxC, SoxB2 or Six3. Injection of RNA encoding SoxC into eggs does not enhance neurogenesis. In addition, inhibition of FGF receptors (SU5402) or a morpholino to FGFR1 reduces expression of SoxC. These data indicate that there are common features of neurogenesis in deuterostomes, and that sea urchins employ developmental mechanisms that are distinct from other ambulacraria. PMID:26511925

  18. Emerging neuromodulatory molecules for the treatment of neurogenic erectile dysfunction caused by cavernous nerve injury

    Institute of Scientific and Technical Information of China (English)

    Anthony J. Bella; Guiting Lin; Ilias Cagiannos; Tom F. Lue

    2008-01-01

    Advances in the neurobiology of growth factors, neural development, and prevention of cell death have resulted in a heightened clinical interest for the development of protective and regenerative neuromodulatory strategies for the cavernous nerves (CNs), as therapies for prostate cancer and other pelvic malignancies often result in neuronal damage and debilitating loss of sexual function. Nitric oxide released from the axonal end plates of these nerves within the corpora cavernosa causes relaxation of smooth muscle, initiating the haemodynamic changes of penile erection as well as contributing to maintained tumescence; the loss of CN function is primarily responsible for the development of erectile dysfunction (ED) after pelvic surgery and serves as the primary target for potential neuroprotective or regenerative strategies. Evidence from pre-clinical studies for select neuromodulatory approaches is reviewed, including neurotrophins, glial cell line-derived neurotrophic factors (GDNF), bone morphogenic proteins, immunophilin ligands,erythropoetin (EPO), and stem cells.

  19. [Homeopathic prophylaxis of urinary tract infections in patients with neurogenic bladder dysfunction].

    Science.gov (United States)

    Pannek, J; Jus, M C; Jus, M S

    2012-04-01

    Recurrent urinary tract infections (UTI) in patients with spinal cord injury are a frequent clinical problem. Often, preventive measures are not successful. We present the case reports of five patients with recurrent UTI who received additional homeopathic treatment. Of these patients, three remained free of UTI, whereas UTI frequency was reduced in two patients. Our initial experience with homeopathic prevention of UTI is encouraging. For an evidence-based evaluation of this concept, prospective studies are required. PMID:22419012

  20. [Urethral condyloma in a patient with neurogenic bladder dysfunction: a therapeutic challenge].

    Science.gov (United States)

    Bartel, P; Göcking, K; Pannek, J

    2013-01-01

    Urethral condyloma is a therapeutic challenge. This article reports the case of a patient with spinal cord injury with the incidental finding of a massive spread of urethral condyloma. After removal of the condyloma with biopsy forceps neither recurrence of the condyloma nor a urethral stricture occurred. In patients where intermittent catheterization is performed, condyloma may be dispersed into the bladder, therefore, prompt endoscopic removal is crucial. As condyloma frequently recurs even after complete removal regular controls are mandatory. PMID:22801816

  1. In vitro and in vivo neurogenic potential of mesenchymal stem cells isolated from different sources

    Indian Academy of Sciences (India)

    Ramyani Taran; MamidiMurali Krishna; Gurbind Singh; Susmita Dutta; Ishwar S Parhar; John P John; Ramesh Bhonde; Rajarshi Pal; Anjan Kumar Das

    2014-03-01

    Regenerative medicine is an evolving interdisciplinary topic of research involving numerous technological methods that utilize stem cells to repair damaged tissues. Particularly, mesenchymal stem cells (MSCs) are a great tool in regenerative medicine because of their lack of tumorogenicity, immunogenicity and ability to perform immunomodulatory as well as anti-inflammatory functions. Numerous studies have investigated the role of MSCs in tissue repair and modulation of allogeneic immune responses. MSCs derived from different sources hold unique regenerative potential as they are self-renewing and can differentiate into chondrocytes, osteoblasts, adipocytes, cardiomyocytes, hepatocytes, endothelial and neuronal cells, among which neuronal-like cells have gained special interest. MSCs also have the ability to secrete multiple bioactive molecules capable of stimulating recovery of injured cells and inhibiting inflammation. In this review we focus on neural differentiation potential ofMSCs isolated from different sources and how certain growth factors/small molecules can be used to derive neuronal phenotypes from MSCs. We also discuss the efficacy of MSCs when transplanted in vivo and how they can generate certain neurons and lead to relief or recovery of the diseased condition. Furthermore, we have tried to evaluate the appropriatemerits of different sources of MSCs with respect to their propensity towards neurological differentiation as well as their effectiveness in preclinical studies.

  2. Contribution of Orexin to the Neurogenic Hypertension in BPH/2J Mice.

    Science.gov (United States)

    Jackson, Kristy L; Dampney, Bruno W; Moretti, John-Luis; Stevenson, Emily R; Davern, Pamela J; Carrive, Pascal; Head, Geoffrey A

    2016-05-01

    BPH/2J mice are a genetic model of hypertension associated with an overactive sympathetic nervous system. Orexin is a neuropeptide which influences sympathetic activity and blood pressure. Orexin precursor mRNA expression is greater in hypothalamic tissue of BPH/2J compared with normotensive BPN/3J mice. To determine whether enhanced orexinergic signaling contributes to the hypertension, BPH/2J and BPN/3J mice were preimplanted with radiotelemetry probes to compare blood pressure 1 hour before and 5 hours after administration of almorexant, an orexin receptor antagonist. Mid frequency mean arterial pressure power and the depressor response to ganglion blockade were also used as indicators of sympathetic nervous system activity. Administration of almorexant at 100 (IP) and 300 mg/kg (oral) in BPH/2J mice during the dark-active period (2 hours after lights off) markedly reduced blood pressure (-16.1 ± 1.6 and -11.0 ± 1.1 mm Hg, respectively;Pblood pressure during the dark (P=0.79) or light periods (P=0.24). Almorexant attenuated the depressor response to ganglion blockade (P=0.018) and reduced the mid frequency mean arterial pressure power in BPH/2J mice (Phypertension during the dark period in BPH/2J mice.

  3. Comparison of neurogenic effects of fluoxetine, duloxetine and running in mice

    NARCIS (Netherlands)

    M.W. Marlatt; P.J. Lucassen; H. van Praag

    2010-01-01

    Hippocampal neurogenesis can be regulated by extrinsic factors, such as exercise and antidepressants. While there is evidence that the selective serotonin reuptake inhibitor (SSRI) fluoxetine enhances neurogenesis, the new dual serotonergic-noradrenergic reuptake inhibitor (SNRI) duloxetine has not

  4. Developmental cues and persistent neurogenic potential within an in vitro neural niche

    Directory of Open Access Journals (Sweden)

    Fairchild Corinne L

    2010-01-01

    Full Text Available Abstract Background Neurogenesis, the production of neural cell-types from neural stem cells (NSCs, occurs during development as well as within select regions of the adult brain. NSCs in the adult subependymal zone (SEZ exist in a well-categorized niche microenvironment established by surrounding cells and their molecular products. The components of this niche maintain the NSCs and their definitive properties, including the ability to self-renew and multipotency (neuronal and glial differentiation. Results We describe a model in vitro NSC niche, derived from embryonic stem cells, that produces many of the cells and products of the developing subventricular zone (SVZ and adult SEZ NSC niche. We demonstrate a possible role for apoptosis and for components of the extracellular matrix in the maintenance of the NSC population within our niche cultures. We characterize expression of genes relevant to NSC self-renewal and the process of neurogenesis and compare these findings to gene expression produced by an established neural-induction protocol employing retinoic acid. Conclusions The in vitro NSC niche shows an identity that is distinct from the neurally induced embryonic cells that were used to derive it. Molecular and cellular components found in our in vitro NSC niche include NSCs, neural progeny, and ECM components and their receptors. Establishment of the in vitro NSC niche occurs in conjunction with apoptosis. Applications of this culture system range from studies of signaling events fundamental to niche formation and maintenance as well as development of unique NSC transplant platforms to treat disease or injury.

  5. A new treatment for neurogenic inflammation caused by EV71 with CR2-targeted complement inhibitor

    OpenAIRE

    Qiu Shaofu; Liu Nan; Jia Leili; Yang Guang; Su Wenli; Li Jing; Song Lixue; Yang Chaojie; Wang Jian; Zhang Chuanfu; Wang Zhongqiang; Qiao Fei; Tomlinson Stephen; Atkinson Carl; Sun Yansong

    2012-01-01

    Abstract Background Enterovirus 71 (EV71), one of the most important neurotropic EVs, has caused death and long-term neurological sequelae in hundreds of thousands of young children in the Asia-Pacific region in the past decade. The neurological diseases are attributed to infection by EV71 inducing an extensive peripheral and central nervous system (CNS) inflammatory response with abnormal cytokine production and lymphocyte depletion induced by EV71 infection. In the absence of specific antiv...

  6. Global expression profiling of globose basal cells and neurogenic progression within the olfactory epithelium.

    Science.gov (United States)

    Krolewski, Richard C; Packard, Adam; Schwob, James E

    2013-03-01

    Ongoing, lifelong neurogenesis maintains the neuronal population of the olfactory epithelium in the face of piecemeal neuronal turnover and restores it following wholesale loss. The molecular phenotypes corresponding to different stages along the progression from multipotent globose basal cell (GBC) progenitor to differentiated olfactory sensory neuron are poorly characterized. We used the transgenic expression of enhanced green fluorescent protein (eGFP) and cell surface markers to FACS-isolate ΔSox2-eGFP(+) GBCs, Neurog1-eGFP(+) GBCs and immature neurons, and ΔOMP-eGFP(+) mature neurons from normal adult mice. In addition, the latter two populations were also collected 3 weeks after olfactory bulb ablation, a lesion that results in persistently elevated neurogenesis. Global profiling of mRNA from the populations indicates that all stages of neurogenesis share a cohort of >2,100 genes that are upregulated compared to sustentacular cells. A further cohort of >1,200 genes are specifically upregulated in GBCs as compared to sustentacular cells and differentiated neurons. The increased rate of neurogenesis caused by olfactory bulbectomy had little effect on the transcriptional profile of the Neurog1-eGFP(+) population. In contrast, the abbreviated lifespan of ΔOMP-eGFP(+) neurons born in the absence of the bulb correlated with substantial differences in gene expression as compared to the mature neurons of the normal epithelium. Detailed examination of the specific genes upregulated in the different progenitor populations revealed that the chromatin modifying complex proteins LSD1 and coREST were expressed sequentially in upstream ΔSox2-eGFP(+) GBCs and Neurog1-eGFP(+) GBCs/immature neurons. The expression patterns of these proteins are dynamically regulated after activation of the epithelium by methyl bromide lesion. PMID:22847514

  7. An experimental method to identify neurogenic and myogenic active mechanical states of intestinal motility

    Directory of Open Access Journals (Sweden)

    Marcello eCosta

    2013-04-01

    Full Text Available Excitatory and inhibitory enteric neural input to intestinal muscle acting on ongoing myogenic activity determines the rich repertoire of motor patterns involved in digestive function. The enteric neural activity cannot yet be established during movement of intact intestine in vivo or in vitro. We propose the hypothesis that is possible to deduce indirectly, but reliably, the state of activation of the enteric neural input to the muscle from measurements of the mechanical state of the intestinal muscle. The fundamental biomechanical model on which our hypothesis is based is the ‘three-element model’ proposed by Hill. Our strategy is based on simultaneous video recording of changes in diameters and intraluminal pressure with a fibre-optic manometry in isolated segments of rabbit colon. We created a composite spatiotemporal map (DPMap from diameter (DMap and pressure changes (PMaps. In this composite map rhythmic myogenic motor patterns can readily be distinguished from the distension induced neural peristaltic contractions. Plotting the diameter changes against corresponding pressure changes at each location of the segment, generates ‘orbits’ that represent the state of the muscle according to its ability to contract or relax actively or undergoing passive changes. With a software developed in MatLab, we identified twelve possible discrete mechanical states and plotted them showing where the intestine actively contracted and relaxed isometrically, auxotonically or isotonically, as well as where passive changes occurred or was quiescent. Clustering all discrete active contractions and relaxations states generated for the first time a spatio-temporal map of where enteric excitatory and inhibitory neural input to the muscle occurs during physiological movements. Recording internal diameter by an impedance probe proved equivalent to measuring external diameter, making possible to further develop similar strategy in vivo and humans.

  8. Elevated cerebrospinal fluid endothelin 1 associated with neurogenic pulmonary edema in children with enterovirus 71 encephalitis

    Directory of Open Access Journals (Sweden)

    Yi-Fang Tu

    2015-05-01

    Conclusion: ET-1 in the central nervous system may play a role in the development of NPE in children with EV71 infection and could be used as a biomarker or therapeutic target for NPE in EV71 encephalitis.

  9. Netrin-5 is highly expressed in neurogenic regions of the adult brain.

    Directory of Open Access Journals (Sweden)

    Satoru eYamagishi

    2015-04-01

    Full Text Available Mammalian netrin family proteins are involved in targeting of axons, neuronal migration, and angiogenesis and act as repulsive and attractive guidance molecules. Netrin-5 is a new member of the netrin family with homology to the C345C domain of netrin-1. Unlike other netrin proteins, murine netrin-5 consists of two EGF motifs of the laminin V domain (LE and the C345C domain, but lacks the N-terminal laminin VI domain and one of the three LE motifs. We generated a specific antibody against netrin-5 to investigate its expression pattern in the rodent adult brain. Strong netrin-5 expression was observed in the olfactory bulb, rostral migrate stream (RMS, the subventricular zone (SVZ, and the subgranular zone (SGZ of the dentate gyrus in the hippocampus, where neurogenesis occurs in the adult brain. In the SVZ and RMS, netrin-5 expression was observed in Mash1-positive transit-amplifying cells and in Doublecortin (DCX-positive neuroblasts, but not in GFAP-positive astrocytes. In the olfactory bulb, netrin-5 expression was maintained in neuroblasts, but its level was decreased in NeuN-positive mature neurons. In the hippocampal SGZ, netrin-5 was observed in Mash1-positive cells and in DCX-positive neuroblasts, but not in GFAP-positive astrocytes, suggesting that netrin-5 expression occurs from type 2a to type 3 cells. These data suggest that netrin-5 is produced by both transit-amplifying cells and neuroblasts to control neurogenesis in the adult brain.

  10. Roles of Wnt Signaling in the Neurogenic Niche of the Adult Mouse Ventricular-Subventricular Zone.

    Science.gov (United States)

    Hirota, Yuki; Sawada, Masato; Huang, Shih-Hui; Ogino, Takashi; Ohata, Shinya; Kubo, Akiharu; Sawamoto, Kazunobu

    2016-02-01

    In many animal species, the production of new neurons (neurogenesis) occurs throughout life, in a specialized germinal region called the ventricular-subventricular zone (V-SVZ). In this region, neural stem cells undergo self-renewal and generate neural progenitor cells and new neurons. In the olfactory system, the new neurons migrate rostrally toward the olfactory bulb, where they differentiate into mature interneurons. V-SVZ-derived new neurons can also migrate toward sites of brain injury, where they contribute to neural regeneration. Recent studies indicate that two major branches of the Wnt signaling pathway, the Wnt/β-catenin and Wnt/planar cell polarity pathways, play essential roles in various facets of adult neurogenesis. Here, we review the Wnt signaling-mediated regulation of adult neurogenesis in the V-SVZ under physiological and pathological conditions. PMID:26572545

  11. Neurogenic Differentiation of Murine Adipose Derived Stem Cells Transfected with EGFP in vitro

    Institute of Scientific and Technical Information of China (English)

    方忠; 杨琴; 熊伟; 李光辉; 肖骏; 郭风劲; 李锋; 陈安民

    2010-01-01

    Some studies indicate that adipose derived stem cells(ADSCs)can differentiate into adipogenic,chondrogenic,myogenic,and osteogenic cells in vitro.However,whether ADSCs can be induced to differentiate into neural cells in vitro has not been clearly demonstrated.In this study,the ADSCs isolated from the murine adipose tissue were cultured and transfected with the EGFP gene,and then the cells were induced for neural differentiation.The morphology of those ADSCs began to change within two days which developed i...

  12. Cutaneous nociception and neurogenic inflammation evoked by PACAP38 and VIP

    DEFF Research Database (Denmark)

    Schytz, Henrik Winther; Holst, Helle; Arendt-Nielsen, Lars;

    2010-01-01

    Pituitary adenylate cyclase-activating peptide-38 (PACAP38) and vasoactive intestinal peptide (VIP) belong to the same secretin-glucagon superfamily and are present in nerve fibers in dura and skin. Using a model of acute cutaneous pain we explored differences in pain perception and vasomotor...... no statistical difference in pain perception between PACAP38 and VIP. Skin blood flow increase, flare and wheal were larger after both PACAP38 (P = 0.011) and VIP (P = 0.001) compared to placebo. VIP induced a considerably larger increase in skin blood flow, flare and wheal than PACAP38 (P = 0...

  13. Hypothalamic tanycytes - masters and servants of metabolic, neuroendocrine and neurogenic functions

    Directory of Open Access Journals (Sweden)

    Timothy eGoodman

    2015-10-01

    Full Text Available There is a resurgent interest in tanycytes, a radial glial-like cell population occupying the floor and ventro-lateral walls of the third ventricle (3V. Tanycytes reside in close proximity to hypothalamic neuronal nuclei that regulate appetite and energy expenditure, with a subset sending projection into these nuclei. Moreover, tanycytes are exposed to 3V cerebrospinal fluid and have privileged access to plasma metabolites and hormones, through fenestrated capillaries. Indeed, some tanycytes act as conduits for trafficking of these molecules into the brain parenchyma. Tanycytes can also act as neural stem/ progenitor cells, supplying the postnatal and adult hypothalamus with new neurons. Collectively, these findings suggest that tanycytes regulate and integrate important trophic and metabolic processes and possibly endow functional malleability to neuronal circuits of the hypothalamus. Hence, manipulation of tanycyte biology could provide a valuable tool for modulating hypothalamic functions such as energy uptake and expenditure in order to tackle prevalent eating disorders such as obesity and anorexia.

  14. Edema pulmonar neurogênico: relato de dois casos Neurogenic pulmonary edema: report of two cases

    OpenAIRE

    Desanka Dragosavac; Antônio L. E. Falcão; Sebastião Araújo; Renato G. G. Terzi

    1997-01-01

    O edema pulmonar neurogênico é rara e grave complicação de pacientes com traumatismo craniencefálico (TCE). Pode ocorrer também em outras patologias do sistema nervoso central, tais como acidentes vasculares cerebrais (AVC), tumores ou após crises epilépticas, entre outras. Foram avaliados 36 casos com TCE grave e quatro pacientes com AVC, internados na UTI geral, no período de janeiro a setembro 1995. Nesse intervalo de tempo foram diagnosticados dois casos de edema pulmonar neurogênico, um ...

  15. Beneficial behavioural and neurogenic effects of agomelatine in a model of depression/anxiety.

    Science.gov (United States)

    Rainer, Quentin; Xia, Lin; Guilloux, Jean-Philippe; Gabriel, Cecilia; Mocaër, Elisabeth; Hen, René; Enhamre, Erika; Gardier, Alain M; David, Denis J

    2012-04-01

    Agomelatine (S20098) is a novel antidepressant drug with melatonergic agonist and 5-HT2C receptor antagonist properties, displaying antidepressant/anxiolytic-like properties in animal models and in humans. In a depression/anxiety-like mouse model in which the response of the HPA axis is blunted, we investigated whether agomelatine could reverse behavioural deficits related to depression/anxiety compared to the classical selective serotonin reuptake inhibitor, fluoxetine. Adult mice were treated for 8 wk with either vehicle or corticosterone (35 μg/ml.d) via drinking water. During the final 4 wk, animals were treated with vehicle, agomelatine (10 or 40 mg/kg i.p.) or fluoxetine (18 mg/kg i.p.) and tested in several behavioural paradigms and also evaluated for home-cage activity. Our results showed that the depressive/anxiety-like phenotype induced by corticosterone treatment is reversed by either chronic agomelatine or fluoxetine treatment. Moreover, agomelatine increased the dark/light ratio of home-cage activity in vehicle-treated mice and reversed the alterations in this ratio induced by chronic corticosterone, suggesting a normalization of disturbed circadian rhythms. Finally, we investigated the effects of this new antidepressant on neurogenesis. Agomelatine reversed the decreased cell proliferation in the whole hippocampus in corticosterone-treated mice and increased maturation of newborn neurons in both vehicle- and corticosterone-treated mice. Overall, the present study suggests that agomelatine, with its distinct mechanism of action based on the synergy between the melatonergic agonist and 5-HT2C antagonist properties, provides a distinct antidepressant/anxiolytic spectrum including circadian rhythm normalization. PMID:21473810

  16. Multiple roles of β-catenin in controlling the neurogenic niche for midbrain dopamine neurons

    OpenAIRE

    Tang, Mianzhi; MIYAMOTO, Yasunori; Huang, Eric J.

    2009-01-01

    Stem cell-based replacement therapy has emerged as a potential strategy to alleviate specific features of movement disorder in Parkinson's disease. However, the current strategy to produce dopamine (DA) neurons from embryonic stem cells has many limitations, including the difficulty of generating DA neurons with high yields. Further insights into the mechanisms that control the neurogenesis of DA neurons will reduce or mitigate such limitations. It is well established ...

  17. Effect of exercise on neurogenic inflammation in spinal cord of Type 1 diabetic rats.

    Science.gov (United States)

    Thakur, Vikram; Gonzalez, Mayra; Pennington, Kristen; Nargis, Syeda; Chattopadhyay, Munmun

    2016-07-01

    Neuropathy is a long-standing and hard to treat complication of diabetes that interferes almost 25-30% of diabetic patients and impacts the quality of life of the patients. Unforeseen side effects, dependency and addiction made the existing medical treatments comparatively ineffective. A number of studies indicate that moderate physical activity provides health-related advantages. However, existing data do not confirm whether regular physical activity would reduce the amount of inflammation in the nervous system of the subjects with Type 1 diabetes. This study reveals the significance of exercise to alleviate inflammation in the spinal cord of the nervous system and preserve sensory nerve function in animals with Type 1 diabetes after 6 weeks of exercise paradigm. Streptozotocin-diabetic animals were placed in motorized running wheels for sixty minutes per day, for five days a week for 6 weeks starting at one week after diabetes. Emerging evidence suggests that the increases in inflammatory mediators play an important role in the development of sensory neuropathy. This study shows that moderate exercise can reduce the release of a number of proinflammatory cytokines in the dorsal horn (DH) of spinal cord, subsequently delaying the development of neuropathy along with an increase in the anti-inflammatory mediator IL10 in the DH. In general, this study indicates that exercise may provide an alternative to the treatment for sensory neuropathy in Type 1 diabetic subjects via reducing the use of medication and providing an easier way to manage neuropathy. PMID:27018295

  18. Cutaneous nociception and neurogenic inflammation evoked by PACAP38 and VIP

    DEFF Research Database (Denmark)

    Schytz, Henrik Winther; Holst, Helle; Arendt-Nielsen, Lars;

    2010-01-01

    Pituitary adenylate cyclase-activating peptide-38 (PACAP38) and vasoactive intestinal peptide (VIP) belong to the same secretin-glucagon superfamily and are present in nerve fibers in dura and skin. Using a model of acute cutaneous pain we explored differences in pain perception and vasomotor res...

  19. Neurogenic tumors and tumor-like lesions of the oral and maxillofacial region: A clinicopathological study

    Directory of Open Access Journals (Sweden)

    Ohoud Alotaibi

    2016-04-01

    Conclusion: This analysis showed that neural lesions affecting the oral and maxillofacial region were rare and mostly benign in nature. Such lesions should be carefully diagnosed because of their association with life-threatening syndromes and the possibility of malignant transformation.

  20. SCHWANNOMA OF THE CERVICAL VAGUS NERVE: A RARE BENIGN NEUROGENIC TUMOR

    Directory of Open Access Journals (Sweden)

    Gokce SIMSEK

    2013-06-01

    Full Text Available A schwannoma, also known as an acoustic neuroma, is a benign nerve sheath tumor composed of schwann cells, which normally produce the insulating myelin sheath covering the peripheral nerves. Schwannoma, originating from the cervical vagus nerve, is an extremely rare neoplasm that usually occurs in men between the 3rd and 6th decades of life. The most common presentation is a painless, slow-growing, lateral neck mass;this appears in a large proportion of cases. Complete surgical resection with care to protect the nerve of origin is the recommended treatment of choice. Here, we report a case of cervical vagal schwannoma in a 55-year-old male who admitted with the complaint of a firm and painless mass lesion on the right side of the neck. The management of the case is discussed along with the relevant literature.

  1. Contribution of Orexin to the Neurogenic Hypertension in BPH/2J Mice.

    Science.gov (United States)

    Jackson, Kristy L; Dampney, Bruno W; Moretti, John-Luis; Stevenson, Emily R; Davern, Pamela J; Carrive, Pascal; Head, Geoffrey A

    2016-05-01

    BPH/2J mice are a genetic model of hypertension associated with an overactive sympathetic nervous system. Orexin is a neuropeptide which influences sympathetic activity and blood pressure. Orexin precursor mRNA expression is greater in hypothalamic tissue of BPH/2J compared with normotensive BPN/3J mice. To determine whether enhanced orexinergic signaling contributes to the hypertension, BPH/2J and BPN/3J mice were preimplanted with radiotelemetry probes to compare blood pressure 1 hour before and 5 hours after administration of almorexant, an orexin receptor antagonist. Mid frequency mean arterial pressure power and the depressor response to ganglion blockade were also used as indicators of sympathetic nervous system activity. Administration of almorexant at 100 (IP) and 300 mg/kg (oral) in BPH/2J mice during the dark-active period (2 hours after lights off) markedly reduced blood pressure (-16.1±1.6 and -11.0±1.1 mm Hg, respectively;P<0.001 compared with vehicle). However, when almorexant (100 mg/kg, IP) was administered during the light-inactive period (5 hours before lights off) no reduction from baseline was observed (P=0.64). The same dose of almorexant in BPN/3J mice had no effect on blood pressure during the dark (P=0.79) or light periods (P=0.24). Almorexant attenuated the depressor response to ganglion blockade (P=0.018) and reduced the mid frequency mean arterial pressure power in BPH/2J mice (P<0.001), but not BPN/3J mice (P=0.70). Immunohistochemical labeling revealed that BPH/2J mice have 29% more orexin neurons than BPN/3J mice which are preferentially located in the lateral hypothalamus. The results suggest that enhanced orexinergic signaling contributes to sympathetic overactivity and hypertension during the dark period in BPH/2J mice. PMID:26975709

  2. Neurogenic orthostatic hypotension of Parkinson's disease: what exploration for what treatment?

    Science.gov (United States)

    Senard, J-M; Pathak, A

    2010-10-01

    The aim of this short review is to illustrate, using orthostatic hypotension as an example, the clinical problems related to autonomic features in Parkinson's disease. Orthostatic hypotension is frequently encountered in Parkinson's disease and its diagnosis remains manometric (a fall of at least 20 and/or 10 mmHg in standing blood pressure). It is often associated with supine hypertension to be taken into account before prescribing. To distinguish between the role of disease and of drugs (not only antiparkinsonian drugs), a simple clinical test of autonomic nervous system activity (deep breathing test and standing test with measurement of 30/15 ratio) can be used. When diagnosis with multisystem atrophy is discussed, cardiac [¹²³I]-metaiodobenzylguanidine (MIBG) scintigraphy is of value showing in Parkinson's disease a decreased uptake of the radiopharmaceutical indicating postganglionic sympathetic denervation. Concerning treatment, nonpharmacological methods have to be systematically used since no drug has been specifically evaluated for the treatment of orthostatic hypotension of Parkinson's disease.

  3. Video-assisted thoracic surgery for superior posterior mediastinal neurogenic tumour in the supine position

    Directory of Open Access Journals (Sweden)

    Darlong Laleng

    2009-01-01

    Full Text Available Video-assisted thoracic surgery (VATS for a superior posterior mediastinal lesion is routinely done in the lateral decubitus position similar to a standard thoracotomy using a double-lumen endotracheal tube for one-lung ventilation. This is an area above the level of the pericardium, with the superior thoracic opening as its superior limit and its inferior limit at the plane from the sternal angle to the level of intervertebral disc of thoracic 4 to 5 vertebra lying behind the great vessels. The lateral decubitus position has disadvantages of the double-lumen endotracheal tube getting malpositioned during repositioning from supine position to the lateral decubitus position, shoulder injuries due to the prolonged abnormal fixed posture and rarer injuries of the lower limb. There is no literature related to VATS in the supine position for treating lesions in the posterior mediastinum because the lung tissue falls in the dependent posterior mediastinum and obscures the field of surgery; however, VATS in the supine position is routinely done for lesions in the anterior mediastinum and single-stage bilateral spontaneous pneumothorax. Thus, in the selected cases, ′VATS in supine position′ allows an invasive procedure to be completed in the most stable anatomical posture.

  4. Cortical infarction of the right parietal lobe and neurogenic heart disease A report of three cases

    Institute of Scientific and Technical Information of China (English)

    Fang Li; Yujie Jia

    2012-01-01

    Three male patients were diagnosed with new cortical infarctions of the right parietal lobe on the basis of head magnetic resonance imaging; high-intensity signals indicating lesions in the right parietal lobe were noted on diffusion-weighted images at admission. Two of them presented with left hand weakness, and one exhibited left upper limb weakness. Treatment for improving blood supply to the brain was administered. One patient died suddenly because of ventricular fibrillation 3 days after admission. The other two patients had increased troponin levels and abnormal elec-trocardiograms, and were diagnosed with acute myocardial infarction half a month after admission. When lesions exist in field 7 of the parietal cortex (resulting in paralysis of the contralateral hand), the sympathetic center of the posterior lateral nucleus of the hypothalamus demonstrates compensatory excitement, which easily causes tachyarrhythmia and sudden death. Our experi-mental findings indicate that close electrocardiograph monitoring and cerebral infarction treatment should be standard procedures to predict and help prevent heart disease in patients with cerebral infarction in the right parietal lobe and left upper limb weakness as the main complaint.

  5. THE CURRENT STATE OF THE NEUROGENIC THEORY OF DEPRESSION AND ANXIETY

    OpenAIRE

    Miller, Bradley R.; Hen, René

    2014-01-01

    Newborn neurons are continuously added to the adult hippocampus. Early studies found that adult neurogenesis is impaired in models of depression and anxiety and accelerated by antidepressant treatment. This led to the theory that depression results from impaired adult neurogenesis and restoration of adult neurogenesis leads to recovery. Follow up studies yielded a complex body of often inconsistent results, and the veracity of this theory is uncertain. We propose five criteria for acceptance ...

  6. Cyclin D1 fine-tunes the neurogenic output of embryonic retinal progenitor cells

    Directory of Open Access Journals (Sweden)

    Choi Yoon

    2009-05-01

    Full Text Available Abstract Background Maintaining the correct balance of proliferation versus differentiation in retinal progenitor cells (RPCs is essential for proper development of the retina. The cell cycle regulator cyclin D1 is expressed in RPCs, and mice with a targeted null allele at the cyclin D1 locus (Ccnd1-/- have microphthalmia and hypocellular retinas, the latter phenotype attributed to reduced RPC proliferation and increased photoreceptor cell death during the postnatal period. How cyclin D1 influences RPC behavior, especially during the embryonic period, is unclear. Results In this study, we show that embryonic RPCs lacking cyclin D1 progress through the cell cycle at a slower rate and exit the cell cycle at a faster rate. Consistent with enhanced cell cycle exit, the relative proportions of cell types born in the embryonic period, such as retinal ganglion cells and photoreceptor cells, are increased. Unexpectedly, cyclin D1 deficiency decreases the proportions of other early born retinal neurons, namely horizontal cells and specific amacrine cell types. We also found that the laminar positioning of horizontal cells and other cell types is altered in the absence of cyclin D1. Genetically replacing cyclin D1 with cyclin D2 is not efficient at correcting the phenotypes due to the cyclin D1 deficiency, which suggests the D-cyclins are not fully redundant. Replacement with cyclin E or inactivation of cyclin-dependent kinase inhibitor p27Kip1 restores the balance of RPCs and retinal cell types to more normal distributions, which suggests that regulation of the retinoblastoma pathway is an important function for cyclin D1 during embryonic retinal development. Conclusion Our findings show that cyclin D1 has important roles in RPC cell cycle regulation and retinal histogenesis. The reduction in the RPC population due to a longer cell cycle time and to an enhanced rate of cell cycle exit are likely to be the primary factors driving retinal hypocellularity and altered output of precursor populations in the embryonic Ccnd1-/- retina.

  7. Clinical guidelines for male lower urinary tract symptoms associated with non-neurogenic overactive bladder

    Directory of Open Access Journals (Sweden)

    Chung-Cheng Wang

    2015-03-01

    Full Text Available The purpose of this guideline is to direct urologists and patients regarding how to identify overactive bladder (OAB in male patients with lower urinary tract symptoms (LUTS and to make an accurate diagnosis and establish treatment goals to improve the patients' quality of life (QoL. LUTS are commonly divided into storage, voiding, and postmicturition symptoms, and are highly prevalent in elderly men. LUTS can result from a complex interplay of pathophysiologic features that can include bladder dysfunction and bladder outlet dysfunction such as benign prostatic obstruction (BPO or poor relaxation of the urethral sphincter. Diagnosis of OAB in male LUTS leads to accurate diagnosis of pure OAB and bladder outlet-related OAB, and appropriate treatment in men with residual storage symptoms after treatment for LUTS.

  8. Potential Therapies by Stem Cell-Derived Exosomes in CNS Diseases: Focusing on the Neurogenic Niche

    OpenAIRE

    Luarte, Alejandro; Bátiz, Luis Federico; Wyneken, Ursula; Lafourcade, Carlos

    2016-01-01

    Neurodegenerative disorders are one of the leading causes of death and disability and one of the biggest burdens on health care systems. Novel approaches using various types of stem cells have been proposed to treat common neurodegenerative disorders such as Alzheimer's Disease, Parkinson's Disease, or stroke. Moreover, as the secretome of these cells appears to be of greater benefit compared to the cells themselves, the extracellular components responsible for its therapeutic benefit have be...

  9. Potential Therapies by Stem Cell-Derived Exosomes in CNS Diseases: Focusing on the Neurogenic Niche

    OpenAIRE

    Luarte, Alejandro; Bátiz, Luis Federico; Wyneken, Ursula; Lafourcade, Carlos

    2016-01-01

    Neurodegenerative disorders are one of the leading causes of death and disability and one of the biggest burdens on health care systems. Novel approaches using various types of stem cells have been proposed to treat common neurodegenerative disorders such as Alzheimer’s Disease, Parkinson’s Disease, or stroke. Moreover, as the secretome of these cells appears to be of greater benefit compared to the cells themselves, the extracellular components responsible for its therapeutic benefit have be...

  10. Duration of off-loading and recurrence rate in Charcot osteo-arthropathy treated with less restrictive regimen with removable walker

    DEFF Research Database (Denmark)

    Christensen, Tomas M; Gade-Rasmussen, Birthe; Pedersen, Lis W;

    2013-01-01

    Recent literature on acute diabetic Charcot osteoarthropathy (CA) reports unusually long periods of off-loading. Data suggest that this might increase the re-currence rate. Subsequently we evaluated the influence of duration of off-loading on the risk of required re-casting....

  11. 浅谈血友病性骨关节病的X线表现%Introduction to X-ray manifestations of hemophilic arthropathy

    Institute of Scientific and Technical Information of China (English)

    郭剑华; 姚艳梅

    2014-01-01

    目的:结合本院收集的多个病例,分析血友病性骨关节病的X线表现,提高对该病的认识。方法结合本院多年来收集的20例血友病性骨关节病的临床与X线表现,并分析文献所见。结果20例病例中均为多发,其中单侧膝关节合并单侧肩关节12例,双侧膝关节8例,双侧膝关节并单侧肩关节13例;均可见股骨髁间窝明显增宽加深,关节间隙明显变窄15例,轻度变窄5例。7例见肱骨外科颈处见分叶状囊样透亮区。结论血友病的关节受累常出现于容易受伤和承受重力的四肢大关节,膝关节最为常见,股骨髁间凹的变宽、变深,髌骨呈方形,被认为是血友病较特征的表现。%Objective To raise awareness to this kind of disease by reviewing the X-ray findings of osteoarthrosis of hemophilia within multiple cases of our collection. Methods Combined with 20 cases were collected in our hospital for many years the clinical and X-ray findings of hemophilia osteoarthropathy, and review the literature. Results 20 cases were multiple, including unilateral knee joint merger unilateral shoulder joint in 12 cases, 15 cases were bilateral knee, bilateral knee joint merger unilateral shoulder joint (13 cases). All visible between the femoral condyle nest widened significantly darker, joint space narrowing obviously 15 cases, mild narrowing in 5cases. 7cases of humerus surgical neck dispose bright leaf capsule sample area. Conclusion Hemophilia joints involved often appeared in the vulnerable and limbs large joints under the force of gravity, the knee, the ost common femoral condyle between concave change wide, deep, patellar shows square, is regarded as hemophilia osteoarthropathy is characteristic performance.

  12. Examining Reactive Arthropathy in Military Skeletal Assemblages: A Pilot Study Using the Mass Grave Assemblage from the Battle of Towton (1461)

    OpenAIRE

    Meghan Elizabeth Banton

    2014-01-01

    Military personnel are often subjected to physical exertion, sleep deprivation, deficient diets, overcrowding, and stress. All of these influences are capable of compromising the immune system’s ability to ward off disease-causing bacteria, thus explaining why the historical narrative of war is frequently accompanied by reports of death and suffering due to epidemics of infectious diseases. Historically some of the most common infections included: diarrhoea, dysentery, typhoid fever, gonorrho...

  13. Neurogene Entzündung in einem neuen chronischen Tiermodell für allergisches Asthma bronchiale

    OpenAIRE

    Hottenrott, Tilman

    2011-01-01

    In the pathophysiology of allergic bronchial asthma interactions between immunological and neuronal factors play an important role. So far, studies dealing with these mechanisms mostly have been conducted with acute allergen challenge. Nevertheless repetitive challenges are probably more relevant to the situation of human asthma, although they can induce allergen tolerance. Results from earlier studies suggest, that especially nerve growth factor (NGF) is involved in the origin of asthmatic s...

  14. Selective depletion of Mac-1-expressing microglia in rat subventricular zone does not alter neurogenic response early after stroke.

    Science.gov (United States)

    Heldmann, Ursula; Mine, Yutaka; Kokaia, Zaal; Ekdahl, Christine T; Lindvall, Olle

    2011-06-01

    Ischemic stroke induces migration of newly formed neuroblasts, generated by neural stem cells in the adult rat subventricular zone (SVZ), towards the injured striatum where they differentiate into mature neurons. Stroke also leads to accumulation of microglia in the SVZ but their role for neurogenesis is unclear. Here we developed a method for selective depletion of the macrophage antigen complex-1 (Mac-1)-expressing microglia population in the SVZ by intraventricular injection of the immunotoxin Mac-1-saporin in rats. We found that the vast majority of Mac-1+ cells were Iba-1+ microglia. The Mac-1+ population was heterogeneous and included both a small proliferative pool of cells, which was not affected by middle cerebral artery occlusion (MCAO), and a larger subpopulation that changed morphologically into a semi-activated state in response to the insult. This subpopulation did not increase its expression of the phagocytic marker ED1 but exhibited high levels of triggering receptor expressed on myeloid cells-2 (TREM-2), associated with alternative microglia activation. A minor portion of the SVZ Mac-1+ cells originated from the blood early after stroke, but this macrophage population became much more substantial at later stages. Almost 80% reduction of Mac-1-expressing microglia, caused by Mac-1 saporin delivered just before and at 1 week after MCAO, did not alter the numbers of newly formed neuroblasts in the striatum or their migratory distance. These findings indicate that the Mac-1-expressing microglia in the SVZ do not play a major role either for the number of neuroblasts which exit the SVZ or their migration in the striatum early following stroke.

  15. Relationship between urodynamic patterns and lower urinary tract symptoms in Chinese women with a non-neurogenic bladder

    Directory of Open Access Journals (Sweden)

    Linhui Wang

    2016-01-01

    Conclusion: Five UDS patterns were identified among neurologically intact women with LUTS. Functional abnormalities of the detrusor and/or sphincter were the main causes of LUTS, and were correlated with the BOO or SUI status. Thus, the UDS pattern can provide additional information regarding the risk factors for BOO or SUI status, as compared to symptomatic typing.

  16. Promoting effect of small molecules in cardiomyogenic and neurogenic differentiation of rat bone marrow-derived mesenchymal stem cells.

    Science.gov (United States)

    Khanabdali, Ramin; Saadat, Anbarieh; Fazilah, Maizatul; Bazli, Khairul Fidaa' Khairul; Qazi, Rida-e-Maria; Khalid, Ramla Sana; Hasan Adli, Durriyyah Sharifah; Moghadamtousi, Soheil Zorofchian; Naeem, Nadia; Khan, Irfan; Salim, Asmat; Shamsuddin, ShamsulAzlin Ahmad; Mohan, Gokula

    2016-01-01

    Small molecules, growth factors, and cytokines have been used to induce differentiation of stem cells into different lineages. Similarly, demethylating agents can trigger differentiation in adult stem cells. Here, we investigated the in vitro differentiation of rat bone marrow mesenchymal stem cells (MSCs) into cardiomyocytes by a demethylating agent, zebularine, as well as neuronal-like cells by β-mercaptoethanol in a growth factor or cytokines-free media. Isolated bone marrow-derived MSCs cultured in Dulbecco's Modified Eagle's Medium exhibited a fibroblast-like morphology. These cells expressed positive markers for CD29, CD44, and CD117 and were negative for CD34 and CD45. After treatment with 1 μM zebularine for 24 hours, the MSCs formed myotube-like structures after 10 days in culture. Expression of cardiac-specific genes showed that treated MSCs expressed significantly higher levels of cardiac troponin-T, Nkx2.5, and GATA-4 compared with untreated cells. Immunocytochemical analysis showed that differentiated cells also expressed cardiac proteins, GATA-4, Nkx 2.5, and cardiac troponin-T. For neuronal differentiation, MSCs were treated with 1 and 10 mM β-mercaptoethanol overnight for 3 hours in complete and serum-free Dulbecco's Modified Eagle's Medium, respectively. Following overnight treatment, neuron-like cells with axonal and dendritic-like projections originating from the cell body toward the neighboring cells were observed in the culture. The mRNA expression of neuronal-specific markers, Map2, Nefl, Tau, and Nestin, was significantly higher, indicating that the treated cells differentiated into neuronal-like cells. Immunostaining showed that differentiated cells were positive for the neuronal markers Flk, Nef, Nestin, and β-tubulin.

  17. Facial nerve intra parotid neuromas. Report of 2 cases; Tumeurs neurogenes intraparotidiennes du nerf facial. Interet de l`IRM

    Energy Technology Data Exchange (ETDEWEB)

    Fisch-Ponsot, C.; Sigal, R.; Schmutz, G.; Dacher, J.N.; Brazeau-Lamontagne, L.; Marchand, F.; Dorion, D. [Centre Universitaire de sante de l`Estrie, Shebrooke (Canada)

    1997-09-01

    Facial nerve intra-parotid neuromas are rare. We report two cases with no facial paralysis. In the first case, the clinical protocol for the evaluation of a parotid mass did not suggest the intra-mastoid tumor extension. This tumor extension was shown by CT and MRI and confirmed by gross and microscopic appearance. In the second case, no intrapretrous extension was observed with MRI. The diagnosis of neuroma was made during surgery. With a literature review, we discuss the diagnostic difficulties encountered in the investigation of parotid facial nerve tumors, emphasizing on the usefulness of CT and MRI in its diagnosis. (authors). 14 refs.

  18. Targeting systemic inflammation in patients with obesity-related pain: Neurogenic thoracic outlet syndrome: an often overlooked but treatable condition.

    Science.gov (United States)

    Pritzlaff, Scott; Carinci, Adam J; Christo, Paul J

    2013-09-01

    Rely primarily on a patient's history and your physical examination findings in considering the diagnosis. Physical therapy, tricyclic antidepressants or SNRIs, and botulinum toxin type A injections can help control symptoms.

  19. A comparison of mindfulness-based stress reduction and an active control in modulation of neurogenic inflammation

    OpenAIRE

    Rosenkranz, Melissa A.; Davidson, Richard J.; MacCoon, Donal G.; Sheridan, John F.; Kalin, Ned H.; Lutz, Antoine

    2012-01-01

    Psychological stress is a major provocative factor of symptoms in chronic inflammatory conditions. In recent years, interest in addressing stress responsivity through meditation training in health-related domains has increased astoundingly, despite a paucity of evidence that reported benefits are specific to meditation practice. We designed the present study to rigorously compare an 8-week Mindfulness-Based Stress Reduction (MBSR) intervention to a well-matched active control intervention, th...

  20. Differential effects of topically applied formalin and aromatic compounds on neurogenic-mediated microvascular leakage in rat skin.

    Science.gov (United States)

    Futamura, Masaki; Goto, Shiho; Kimura, Ryoko; Kimoto, Izumi; Miyake, Mio; Ito, Komei; Sakamoto, Tatsuo

    2009-01-01

    Various volatile organic compounds (VOCs) act as a causative agent of skin inflammation. We investigated the effect of topical application of several VOCs and formalin on microvascular leakage in rat skin. We tested capsaicin, which is a reagent that specifically causes the skin response via endogenously released tachykinins. Evans blue dye extravasation served as an index of the increase in skin vascular permeability. After shaving the abdomen, we applied formalin, m-xylene, toluene, styrene, benzene, ethylbenzene, acetone, diethyl ether, hexane, heptane, cyclohexane and capsaicin to the skin. At 40min after application, skin samples were collected. Among all of the VOCs tested, all of the aromatic compounds significantly produced skin microvascular leakage that was similar to formalin and capsaicin. We also investigated the skin responses seen after the intravenous administration of CP-99,994 (1.5 or 5mg/kg), which is a tachykinin NK1 receptor antagonist, ketotifen (1 or 3mg/kg), which is a histamine H1 receptor antagonist that stabilizes the mast cells, and the topical application of capsazepine (22.5 or 50mM), which is the transient receptor potential vanilloid 1 (TRPV1) antagonist. The response induced by formalin and capsaicin was completely inhibited by CP-99,994. On the other hand, the antagonist partially reduced the response induced by m-xylene, toluene and styrene by 39%, 50% and 46%, respectively. Capsazepine and ketotifen did not alter the response induced by formalin or any of the aromatic compounds. Like capsaicin, formalin and the aromatic compounds at least partially caused skin microvascular leakage, which was due to tachykinin NK1 receptor activation related to the release of tachykinins from the sensory nerve endings. However, it is unlikely that mast cells and TRPV1 play an important role in the skin response.

  1. Effectiveness of Rehabilitative Balloon Swallowing Treatment on Upper Esophageal Sphincter Relaxation and Pharyngeal Motility for Neurogenic Dysphagia

    OpenAIRE

    Kim, Yong Kyun; Choi, Sung Sik; Choi, Jung Hwa; Yoon, Jeong-Gyu

    2015-01-01

    Objective To investigate the relationship between dysphagia severity and opening of the upper esophageal sphincter (UES), and to assess the effect of balloon size on functional improvement after rehabilitative balloon swallowing treatment in patients with severe dysphagia with cricopharyngeus muscle dysfunction (CPD). Methods We reviewed videofluoroscopic swallowing studies (VFSS) conducted in the Department of Physical Medicine and Rehabilitation, Myongji Hospital from January through Decemb...

  2. NTPDase2 and Purinergic Signaling Control Progenitor Cell Proliferation in Neurogenic Niches of the Adult Mouse Brain

    OpenAIRE

    Gampe, Kristine; Stefani, Jennifer; Hammer, Klaus; Brendel, Peter; Pötzsch, Alexandra; Enikolopov, Grigori; Enjyoji, Keiichi; Acker-Palmer, Amparo; Robson, Simon C.; Zimmermann, Herbert

    2015-01-01

    Nerve cells are continuously generated from stem cells in the adult mammalian subventricular zone (SVZ) and hippocampal dentate gyrus. We have previously noted that stem/progenitor cells in the SVZ and the subgranular layer (SGL) of the dentate gyrus express high levels of plasma membrane-bound nucleoside triphosphate diphosphohydrolase 2 (NTPDase2), an ectoenzyme that hydrolyzes extracellular nucleoside di- and triphosphates. We inferred that deletion of NTPDase2 would increase local extrace...

  3. A dynamic code of dorsal neural tube genes regulates the segregation between neurogenic and melanogenic neural crest cells.

    Science.gov (United States)

    Nitzan, Erez; Krispin, Shlomo; Pfaltzgraff, Elise R; Klar, Avihu; Labosky, Patricia A; Kalcheim, Chaya

    2013-06-01

    Understanding when and how multipotent progenitors segregate into diverse fates is a key question during embryonic development. The neural crest (NC) is an exemplary model system with which to investigate the dynamics of progenitor cell specification, as it generates a multitude of derivatives. Based on 'in ovo' lineage analysis, we previously suggested an early fate restriction of premigratory trunk NC to generate neural versus melanogenic fates, yet the timing of fate segregation and the underlying mechanisms remained unknown. Analysis of progenitors expressing a Foxd3 reporter reveals that prospective melanoblasts downregulate Foxd3 and have already segregated from neural lineages before emigration. When this downregulation is prevented, late-emigrating avian precursors fail to upregulate the melanogenic markers Mitf and MC/1 and the guidance receptor Ednrb2, generating instead glial cells that express P0 and Fabp. In this context, Foxd3 lies downstream of Snail2 and Sox9, constituting a minimal network upstream of Mitf and Ednrb2 to link melanogenic specification with migration. Consistent with the gain-of-function data in avians, loss of Foxd3 function in mouse NC results in ectopic melanogenesis in the dorsal tube and sensory ganglia. Altogether, Foxd3 is part of a dynamically expressed gene network that is necessary and sufficient to regulate fate decisions in premigratory NC. Their timely downregulation in the dorsal neural tube is thus necessary for the switch between neural and melanocytic phases of NC development.

  4. A case of idiopathic diabetes insipidus presented with bilateral hydroureteronephrosis and neurogenic bladder: A pediatric case report and literature review.

    Science.gov (United States)

    Yuksel, Ozgur Haki; Kivrak, Mithat; Sahin, Aytac; Akan, Serkan; Urkmez, Ahmet; Verit, Ayhan

    2015-01-01

    Diabetes insipidus (DI) is a condition with heterogeneous clinical symptoms characterized by polyuria (urine output >4 mL/kg/hr) and polydipsia (water intake >2 L/m (2)/d). In children, acquired nephrogenic DI (NDI) is more common than central DI (CDI). Diagnosis is based on the presence of high plasma osmolality and low urinary osmolality with significant water diuresis. A water deprivation test with vasopressin challenge, though has limitations, is done to differentiate NDI from CDI and diagnose their incomplete forms. Neonates and young infants are better managed with hydration therapy alone. Older children with CDI are treated with desmopressin (1-deamino-8-D-arginine vasopressin, dDAVP). Its oral form is safe, highly effective and has dosing flexibility. We report a case of an 8-year-old male patient with CDI with severe bilateral non-obstructive hydronephrosis and megaureter. Dramatic clinical and radiological responses to dDAVP treatment were achieved and therapy reduced urine volume and led to marked radiological improvement in hydronephrosis. PMID:26600892

  5. The pattern of distribution of laminin in neurogenic tumors, granular cell tumors, and nevi of the oral mucosa

    DEFF Research Database (Denmark)

    Reibel, J; Wewer, U; Albrechtsen, R

    1985-01-01

    . Accentuated staining was seen in Verocay bodies. In granular cell myoblastomas (GCM), small groups of tumor cells were encircled by laminin-positive material, whereas individual tumor cells were unstained. In nevi, diffusely spread nevus cells were surrounded by a rim of laminin, whereas when arranged in...... in differential diagnosis of soft tissue tumors and may provide useful information about the pathogenesis of various lesions....

  6. The Low-field MRI Appearance of Diabetic Foot%糖尿病足的低场MRI影像表现

    Institute of Scientific and Technical Information of China (English)

    赵绘萍; 蒋高民

    2011-01-01

    目的:探讨MRI 对糖尿病足的诊断价值.方法:回顾性分析23 例30 足糖尿病足的MRI 影像特点,总结其MRI 影像表现,明确MRI 对糖尿病足的诊断价值.结果:糖尿病足MRI 表现:①软组织水肿,②软组织溃疡,③骨髓炎,④神经性骨关节病,⑤关节腔积液,⑥关节脱位.结论:MRI 可清晰显示糖尿病足的病理变化特点,对糖尿病足的影像诊断具有较高的临床实用价值.%Objective:To investigate the diagnostic value of MRI of diabetic foot.Methods:The MRI imaging of 30 feet were reviewed,to investigate the diagnostic value of MRI of diabetic foot.Results:The MRI imaging of diabetic foot:①edema of soft tissue,②ulcer of tissue soft, ③osteomyelitis,④neurogenic arthropathy,⑤articular cavity effusion,⑥dislocation of joint Conclusion:The pathologic characters of diabetic foot could be displayed clearly,MRI is valuable in imaging diagnosis of diabetic foot.

  7. Disease: H00526 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available H00526 Camptodactyly-arthropathy-coxa vara-pericarditis syndrome; Jacobs syndrome T...he camptodactyly-arthropathy-coxa vara-pericarditis syndrome (CACP) is an autosomal recessive disorder cause...with camptodactyly. Some patients have pericarditis with effusions. Developmental disorder PRG4 [HSA:10216] ...ptodactyly-arthropathy-coxa vara-pericarditis syndrome. Pediatr Dev Pathol 8:26-33 (2005) PMID:16429407 (des...ieur AM, Hasson N, Hall CM Camptodactyly-arthropathy-coxa vara-pericarditis syndrome versus juvenile idiopathic arthropathy. AJR Am J Roentgenol 185:522-9 (2005) ...

  8. A comparative study of renal dysfunction in patients with inflammatory arthropathies: strong association with cardiovascular diseases and not with anti-rheumatic therapies, inflammatory markers or duration of arthritis.

    LENUS (Irish Health Repository)

    Haroon, Muhammad

    2012-02-01

    AIMS: The aim of this study was to investigate the prevalence of chronic kidney disease (CKD) among comparable patients with rheumatoid arthritis (RA) and seronegative inflammatory arthritis, and to explore any predictive factors for renal impairment. METHODS: Consecutive patients with peripheral joint disease (oligo and polyarthritis) were recruited from our inflammatory arthritis clinics. We divided patients in two groups: RA group and seronegative inflammatory arthritis group. The cohort consisted of 183 patients (RA = 107, seronegative arthritis = 76 [psoriatic arthritis = 69, undifferentiated oligoarthritis = 7]). Estimated glomerular filtration rate (eGFR) was calculated using the established Modification of Diet in Renal Disease equation. Demographic details, disease-specific characteristics, anti-rheumatic drugs and the presence of cardiovascular diseases were recorded. RESULTS: In total, 17.48% (n = 32) of the cohort had CKD. There was no statistically significant variation between the two groups as regards baseline demographics, disease characteristics, use of anti-rheumatic drugs and the presence of individual cardiovascular diseases. We found that eGFR and the presence of CKD were similar among these groups. Among patients with CKD, 72% had undiagnosed CKD. No association of statistical significance was noted between CKD and the use of corticosteroids, disease-modifying antirheumatic drugs and anti-tumor necrosis factor agents. The association of cardiovascular diseases with CKD remained significant after adjusting for confounders (age, gender, duration of arthritis, high C-reactive protein, use of anti-rheumatic drugs). CONCLUSIONS: Patients with inflammatory arthritis are more prone to have CKD. This could have serious implications, as the majority of rheumatology patients use non-steroidal anti-inflammatory drugs and different immunosuppressives, such as methotrexate. No association of kidney dysfunction was noted with inflammatory disease-specific characteristics; rather it appears to have a positive independent association with cardiovascular diseases.

  9. New cinnamic - N-benzylpiperidine and cinnamic - N,N-dibenzyl(N-methyl)amine hybrids as Alzheimer-directed multitarget drugs with antioxidant, cholinergic, neuroprotective and neurogenic properties.

    Science.gov (United States)

    Estrada, Martín; Herrera-Arozamena, Clara; Pérez, Concepción; Viña, Dolores; Romero, Alejandro; Morales-García, José A; Pérez-Castillo, Ana; Rodríguez-Franco, María Isabel

    2016-10-01

    Here we describe new families of multi-target directed ligands obtained by linking antioxidant cinnamic-related structures with N-benzylpiperidine (NBP) or N,N-dibenzyl(N-methyl)amine (DBMA) fragments. Resulting hybrids, in addition to their antioxidant and neuroprotective properties against mitochondrial oxidative stress, are active at relevant molecular targets in Alzheimer's disease, such as cholinesterases (hAChE and hBuChE) and monoamine oxidases (hMAO-A and hMAO-B). Hybrids derived from umbellic - NBP (8), caffeic - NBP (9), and ferulic - DBMA (12) displayed balanced biological profiles, with IC50s in the low-micromolar and submicromolar range for hChEs and hMAOs, and an antioxidant potency comparable to vitamin E. Moreover, the caffeic - NBP hybrid 9 is able to improve the differentiation of adult SGZ-derived neural stem cells into a neuronal phenotype in vitro. PMID:27267007

  10. Cerebrolysin bei Schädel-Hirn-Trauma - Eine neurotrope und neurogene Substanz in der Initialbehandlung akuter Schädel-Hirn-Verletzungen

    OpenAIRE

    König P; Waanders R; Witzmann A; Lanner G; Haffner Z; Haninec P; Gmeinbauer R; Zimmermann-Meinzingen S

    2006-01-01

    Schädel-Hirn-Verletzungen (SHV, SHT) und daraus resultierende akute wie chronische Traumafolgen werden von der WHO als eine der größten Gesundheitsschädigungen weltweit angesehen. Alle Therapeutika, die dazu beitragen, die Folgen eines SHT zu reduzieren, sind daher von besonderem theoretischem wie praktischem Interesse. Cerebrolysin ist ein standardisiert aus Schweinehirn gewonnenes Peptidgemisch, dessen Eiweißkörper aufgrund ihres niedrigen Molekulargewichtes die Bluthirnschranke zu passie...

  11. Characterization of Neurogenic Potential of Dental Pulp Stem Cells Cultured in Xeno/Serum-Free Condition: In Vitro and In Vivo Assessment

    Directory of Open Access Journals (Sweden)

    Jieun Jung

    2016-01-01

    Full Text Available Neural stem cells (NSCs have a high potency for differentiation to neurons and glial cells for replacement of damaged cells and paracrine effects for the regeneration and remyelination of host axons. Dental pulp is known to have a potential to differentiate into neural-like cells; therefore, dental pulp may be used as an autologous cell source for neural repair. In this study, we selectively expanded stem cells from human dental pulp in an initial culture using NSC media under xeno- and serum-free conditions. At the initial step of primary culture, human dental pulp was divided into two groups according to the culture media: 10% fetal bovine serum medium group (FBS group and NSC culture medium group (NSC group. In the NSC group relative to the FBS group, the expression of NSC markers and the concentrations of leukemia inhibitory factor, nerve growth factor, and stem cell factor were higher, although their expression levels were lower than those of human fetal NSCs. The transplanted cells of the NSC group survived well within the normal brain and injured spinal cord of rats and expressed nestin and Sox2. Under the xeno- and serum-free conditions, autologous human dental pulp-derived stem cells might prove useful for clinical cell-based therapies to repair damaged neural tissues.

  12. Bladder-emptying methods, neurogenic lower urinary tract dysfunction and impact on quality of life in people with long-term spinal cord injury

    NARCIS (Netherlands)

    Adriaansen, Jacinthe J E; van Asbeck, Floris W A; Tepper, Marga; Faber, Willemijn X; Visser-Meily, Johanna M A; de Kort, Laetitia M O; Post, Marcel W M

    2015-01-01

    Objectives To describe bladder-emptying methods used by people with long-term spinal cord injury (SCI) and to determine usage differences in relation to time since injury, sex, lesion level and completeness of lesion. Furthermore, to evaluate the relationship between bladder emptying methods and the

  13. Fluid management in patients with neurogenic pulmonary edema%神经源性肺水肿的液体治疗策略探讨

    Institute of Scientific and Technical Information of China (English)

    冯艳; 于国东; 王华; 余英典; 卢毅荣; 刘占国; 常平

    2015-01-01

    Objective To characterize the disease ofneurogenic pulmonary edema (NPE),and to investigate the optimal fluid therapeutic strategy as well as to assess the role of extravascular lung water index (EVLWI) in management of fluid resuscitation.Methods Data of seven patients with NPE,admitted to our intensive care unit (ICU) from September 2012 to January 2014,were collected and analyzed retrospectively.The continuous cardiac output pulse indication (PICCO) monitoring was implemented as soon as the patients were admitted.Conservative fluid therapeutic strategy was adopted,targeting at decreasing EVLWI as the primary goal and maintaining normal blood volume or mean aortic pressure more than or equal to 65 mmHg as the secondary goal.The hemodynamic parameters and input and output volume of fluid,pulmonary vascular permeability index (PVPI),global end-diastolic volume index (GEDVI),extravascular lung water index (EVLW1),oxygenation index (PaO2/FiO2) and lactic acid (Lac) level,and the chest Ⅹ ray and cranial CT images were recorded and analyzed.The starting point of the record was defined as the time of NPE occurring,and the ending point as time of discharging from ICU or rectification of hypotension or pulmonary edema.Results In a lot of cases,NPE was secondary to severe traumatic brain injury or acute cerebrovascular diseases,concomitant with severe hypotensive shock and pulmonary capillary leakage with a mean PVPI value of 3.3±1.7.The mean fluid input in 7 patients was (2099±1146) mL/d,and the net fluid balance was achieved in a median of-250 mL/d.The mean value of GEDVI was maintained at a level of (727±149) mL/m2.The mean value of EVLWI declined gradually firom (18.0±7.0) mL/kg at the startting point to (10±4.3) mL/kg at the ending point of record,and 5 patients showed significant improvement in lung effusion and brain edema as being illustrated in the chest Ⅹ ray or CT images,1 died and the other abandoned therapy; the mean length of ICU stay was 9 days.Pearson correlation analysis showed that EVLWI was correlated with PaO2/FiO2 and PVPI (r=-0.570 and 0.760,respectively,P<0.05).Conclusion Successful management of NPE relies on an elaborate balance of both improvement of cranial perfusion and prevention of pulmonary edema exacerbation; PICCO monitoring is a useful tool in assessment of the blood volume status,and targeting at the decreasing EVLWI as a goal of fluid resuscitation is of benefit to patients with NPE.%目的 探讨神经源性肺水肿(NPE)的特点及液体治疗策略,评价血管外肺水指数(EVLWI)在液体治疗中的意义. 方法 选择南方医科大学珠江医院重症医学科(ICU)自2012年9月至2014年1月收治的7例NPE病例资料进行回顾性分析,所有患者均给予脉搏指示连续心排血量(PICCO)监测且数据记录完整;治疗采用限制性补液策略,以不增加血管外肺水指数(EVLWI)为主要目标,维持正常血容量或平均动脉压≥65 mmHg为次要目标.以入院为起点,肺水肿吸收/休克纠正或转出ICU为终点,记录液体出入量、肺血管通透性指数(PVPI)、全心舒张末期容积指数(GEDVI)、EVLWI、氧合指数(PaO2/FiO2)、动脉血乳酸(Lac)、X线胸片及头颅CT影像等指标,分析各指标的相互关系. 结果 NPE多继发于重型颅脑损伤和急性脑血管病,均伴有严重的低血压休克和渗透性肺水肿,PVPI均值为3.3±1.7.7例平均液体输入量为(2099±1146)mL/d,中位数液体净平衡为-250 mL/d,白蛋白等胶体液入量占50%以上,维持GEDVI在(727±149) mL/m2.治疗后,EVLWI均值从起点时的(18.0±7.0) mL/kg降至终点时的(10±4.3)mL/kg,5例病情好转,休克纠正,头颅CT未见脑水肿加重;1例死亡,1例自动出院,平均住ICU时间9d.相关分析显示,EVLWI水平与PaO2/FiO2和PVPI存在相关性(r=-0.570,P=0.000;r=0.760,P=0.000). 结论 NPE的液体治疗需兼顾改善脑灌注和避免肺水肿加重两者的平衡,PICCO指标能准确反映患者的血容量状态,以不增加EVLWI作为液体复苏的目标可以提高治疗效果.

  14. Characterization of Neurogenic Potential of Dental Pulp Stem Cells Cultured in Xeno/Serum-Free Condition: In Vitro and In Vivo Assessment

    Science.gov (United States)

    Jung, Jieun; Kim, Jong-Wan; Moon, Ho-Jin; Hong, Jin Young

    2016-01-01

    Neural stem cells (NSCs) have a high potency for differentiation to neurons and glial cells for replacement of damaged cells and paracrine effects for the regeneration and remyelination of host axons. Dental pulp is known to have a potential to differentiate into neural-like cells; therefore, dental pulp may be used as an autologous cell source for neural repair. In this study, we selectively expanded stem cells from human dental pulp in an initial culture using NSC media under xeno- and serum-free conditions. At the initial step of primary culture, human dental pulp was divided into two groups according to the culture media: 10% fetal bovine serum medium group (FBS group) and NSC culture medium group (NSC group). In the NSC group relative to the FBS group, the expression of NSC markers and the concentrations of leukemia inhibitory factor, nerve growth factor, and stem cell factor were higher, although their expression levels were lower than those of human fetal NSCs. The transplanted cells of the NSC group survived well within the normal brain and injured spinal cord of rats and expressed nestin and Sox2. Under the xeno- and serum-free conditions, autologous human dental pulp-derived stem cells might prove useful for clinical cell-based therapies to repair damaged neural tissues.

  15. Cerebrolysin bei Schädel-Hirn-Trauma - Eine neurotrope und neurogene Substanz in der Initialbehandlung akuter Schädel-Hirn-Verletzungen

    Directory of Open Access Journals (Sweden)

    König P

    2006-01-01

    Full Text Available Schädel-Hirn-Verletzungen (SHV, SHT und daraus resultierende akute wie chronische Traumafolgen werden von der WHO als eine der größten Gesundheitsschädigungen weltweit angesehen. Alle Therapeutika, die dazu beitragen, die Folgen eines SHT zu reduzieren, sind daher von besonderem theoretischem wie praktischem Interesse. Cerebrolysin ist ein standardisiert aus Schweinehirn gewonnenes Peptidgemisch, dessen Eiweißkörper aufgrund ihres niedrigen Molekulargewichtes die Bluthirnschranke zu passieren vermögen. Die neurotrophen, neuroprotektiven und neurogenetischen Eigenschaften von Cerebrolysin wurden in verschiedenen präklinischen Studien dokumentiert. Auch für dementielle Hirnerkrankungen und die Schlaganfallbehandlung mit Cerebrolysin liegen klinische Studien vor. Wir führten eine placebokontrollierte Doppelblindstudie mit Cerebrolysin als Add-on-Therapie in der Behandlung akuter SHV in 5 Zentren durch. In die Studie wurden 44 Patienten aufgenommen, 22 in die Verum- und 22 in die Placebogruppe. Beurteilungskriterien waren die GCS (Glasgow-Coma-Scale, die CGI (Clinical-Global-Impression und der SKT (Syndrom-Kurztest, Nebenwirkungen wurden mit der DOTES/TWIS erfaßt. Die Vitalparameter und Laborwerte wurden kontrolliert. Cerebrolysin bzw. Placebo wurde durch 21 Tage einmal täglich i.v. infundiert. Die statistische Analyse der Unterschiede zwischen Therapiebeginn und den wöchentlichen Kontrollen zeigte signifikante Unterschiede zwischen Cerebrolysin und Placebo: Cerebrolysin verbesserte die Hirnleistungsfähigkeit signifikant rascher und deutlicher. Die Verträglichkeit von Cerebrolysin war, wie bekannt, ausgezeichnet. Zusätzlich ergaben sich in zwei spezifischen Behandlungsaspekten relevante Resultate für die Cerebrolysingruppe in der Behandlung des SHT: Einerseits in der praktischen Anwendbarkeit einer Substanz, die sich stabilisierend auf Metabolismus und intrazelluläre Strukturen von Neuronen, somit antiapoptotisch, auswirkt und damit die Remission beschleunigt. Dies reduziert das lokale Ausmaß der Schädigung, erlaubt einen früheren Rehabilitationsbeginn und damit eine mögliche Reduktion der stationären Aufenthaltsdauer. Andererseits ist Cerebrolysin bis dato die erste Substanz, welche in vitro eine dem BDNF vergleichbare Wirkung aufweist, hirngängig und ausgezeichnet verträglich ist, wie aus der Nebenwirkungsdokumentation, aber auch der breiten klinischen Erfahrung hervorgeht. Wegen methodologischer Einschränkungen unserer Untersuchung, nicht zuletzt der Gruppengröße, sollten unter Berücksichtigung der Bedeutung und des Ausmaßes der Folgen von Schädel-Hirn-Verletzungen unsere vorläufigen Resultate unbedingt an größeren Stichproben verifiziert werden.

  16. Validation of a Dutch version of the Actionable 8-item screening questionnaire for neurogenic bladder overactivity in multiple sclerosis: an observational web-based study

    NARCIS (Netherlands)

    Jongen, P.J.; Blok, B.F.; Heesakkers, J.P.F.A.; Heerings, M.; Lemmens, W.A.J.G.; Donders, R.

    2015-01-01

    BACKGROUND: In patients with multiple sclerosis (MS) the impact of urological symptoms on quality of life and daily activities is considerable. Yet, a substantial percentage of patients may not be urologically evaluated and thus fail to be treated concordantly. The 8-item Actionable questionnaire is

  17. Haemarthrosis stimulates the synovial fibrinolytic system in haemophilic mice

    NARCIS (Netherlands)

    Nieuwenhuizen, Laurens; Roosendaal, Goris; Coeleveld, Katja; Lubberts, Erik; Biesma, Douwe H.; Lafeber, Floris P. J. G.; Schutgens, Roger E. G.

    2013-01-01

    Recurrent joint bleeding is the most common manifestation of haemophilia resulting in haemophilic arthropathy (HA). The exact pathophysiology is unknown, but it is suggested that arthropathy is stimulated by liberation of fibrinolytic activators from the synovium during haemarthrosis. The aim of thi

  18. Validation of a New Pediatric Joint Scoring System From the International Hemophilia Prophylaxis Study Group: Validity of the Hemophilia Joint Health Score

    NARCIS (Netherlands)

    Feldman , M. Brian; Funk, M. Sharon; Bergstrom, Britt-Marie; Zourikian, Nichan; Hillard, Pamela; Net, van der Janjaap; Engelbert , H.H. Raoul; Petrini, Pia; Berg, Marijke van den H.; Manco-Johnson, J. Marilyn; Rivard, E. Georges; Abad, Audrey; Blanchette , S. Victor

    2011-01-01

    Objective. Repeated hemarthrosis in hemophilia causes arthropathy with pain and dysfunction. The Hemophilia Joint Health Score (HJHS) was developed to be more sensitive for detecting arthropathy than the World Federation of Hemophilia (WFH) physical examination scale, especially for children and tho

  19. Uso de concentrados autólogos de plaquetas obtenidos mediante el método del tubo como tratamiento de artropatías en caballos Use of autologous platelet concentrates obtained by the tube method as a treatment for arthropathies in horses

    Directory of Open Access Journals (Sweden)

    JU Carmona

    2009-01-01

    Full Text Available Se evaluó el efecto clínico de la inyección intraarticular de un concentrado autólogo de plaquetas (APC en 7 caballos con enfermedad articular grave (4 con osteoartritis y 3 con osteocondrosis. Se documentó el grado de cojera (GC y distensión articular (DA. Se aplicaron tres inyecciones de APCs con un intervalo de dos semanas entre cada aplicación. Los caballos fueron evaluados antes de cada inyección y dos meses después del último tratamiento. Se realizó seguimiento clínico durante un año. Se determinaron los niveles de plaquetas y leucocitos y los niveles de factor de crecimiento transformante beta 1 (TGF-β1 por ml de APC. El APC preparado presentó un promedio de 250 (rango: 140-480 x 10(6 plaquetas y 8,68 (3,3-18 x 10(6 leucocitos por y 12,5 (3-15 ng de TGF-β1 La inyección de los APCs produjo una mejoría clínica en el GC y DA. La mejoría más marcada se observó dos meses después del último tratamiento y persistió durante ocho meses posinyección. No se observaron signos clínicos adversos significativos asociados al tratamiento. A pesar de los efectos aparentemente positivos del APC no se puede recomendar el uso de esa sustancia, hasta que no haya un suficiente número de casos clínicos preferiblemente evaluados mediante un estudio doble ciego controlado.The clinical effect of the intra-articular injection of an autologous platelet concentrate (APC in 7 horses with severe joint disease (4 with osteoarthritis and 3 with osteochondrosis was evaluated. The degree of lameness (DL and joint effusion (JE were recorded. Three injections of the APC were performed at two week intervals. Horses were evaluated before each injection and two months after the last treatment. Clinical follow-up was conducted during 1 year. Count of platelets, leucocytes, and determination of transforming growth factor beta 1 (TGF-β1 levels per ml of the APC were performed. A mean of 250 (range: 140-480 x 10(6 platelets, 8.68 (3.3-18 leucocytes x 10(6, and 12.5 (3-15 ng of TGF-β1 per ml of the APC were obtained. No adverse clinical signs resulted from this treatment. Horses treated with APCs showed a clinical improvement in both the DL and JE. The most remarkable improvement was observed 2 months after the last treatment and apparently persisted up until 8 months later. Despite the seemingly positive effects of this substance, the clinical use of APCs cannot be recommended until further studies with higher number of cases and longer follow up can be undertaken.

  20. Étude du rôle des facteurs de transcription Prdm12 et Prdm13 au cours de la neurogenèse dans la moelle épinière embryonnaire

    OpenAIRE

    Hanotel, Julie

    2015-01-01

    La moelle épinière assure la transmission des messages nerveux entre l’encéphale et le reste du corps et assure la coordination des mouvements rythmiques de la locomotion. Elle est constituée d’un grand nombre de types différents d’interneurones et de neurones moteurs, organisés en circuits neuronaux. Les circuits impliqués dans la transmission des informations sensorielles et dans les mouvements des membres sont localisés respectivement dans les parties dorsale et ventrale de la moelle épin...

  1. Multimodal imaging of subventricular zone neural stem/progenitor cells in the cuprizone mouse model reveals increased neurogenic potential for the olfactory bulb pathway, but no contribution to remyelination of the corpus callosum.

    Science.gov (United States)

    Guglielmetti, Caroline; Praet, Jelle; Rangarajan, Janaki Raman; Vreys, Ruth; De Vocht, Nathalie; Maes, Frederik; Verhoye, Marleen; Ponsaerts, Peter; Van der Linden, Annemie

    2014-02-01

    Multiple sclerosis is a devastating demyelinating disease of the central nervous system (CNS) in which endogenous remyelination, and thus recovery, often fails. Although the cuprizone mouse model allowed elucidation of many molecular factors governing remyelination, currently very little is known about the spatial origin of the oligodendrocyte progenitor cells that initiate remyelination in this model. Therefore, we here investigated in this model whether subventricular zone (SVZ) neural stem/progenitor cells (NSPCs) contribute to remyelination of the splenium following cuprizone-induced demyelination. Experimentally, from the day of in situ NSPC labeling, C57BL/6J mice were fed a 0.2% cuprizone diet during a 4-week period and then left to recover on a normal diet for 8weeks. Two in situ labeling strategies were employed: (i) NSPCs were labeled by intraventricular injection of micron-sized iron oxide particles and then followed up longitudinally by means of magnetic resonance imaging (MRI), and (ii) SVZ NSPCs were transduced with a lentiviral vector encoding the eGFP and Luciferase reporter proteins for longitudinal monitoring by means of in vivo bioluminescence imaging (BLI). In contrast to preceding suggestions, no migration of SVZ NSPC towards the demyelinated splenium was observed using both MRI and BLI, and further validated by histological analysis, thereby demonstrating that SVZ NSPCs are unable to contribute directly to remyelination of the splenium in the cuprizone model. Interestingly, using longitudinal BLI analysis and confirmed by histological analysis, an increased migration of SVZ NSPC-derived neuroblasts towards the olfactory bulb was observed following cuprizone treatment, indicative for a potential link between CNS inflammation and increased neurogenesis.

  2. 骶神经前根电刺激治疗脊髓损伤患者排尿功能障碍%Electrostimulation of anterior sacral nerve roots in the treatment of neurogenic bladder because of spinal cord injury

    Institute of Scientific and Technical Information of China (English)

    田晓军; 周谋望; 赵磊; 谷红雨

    2008-01-01

    目的 探讨骶神经前根电刺激在脊髓损伤患者排尿功能障碍治疗中的应用及疗效.方法 总结2005年10月收治1例C6-7损伤后1年的完全性截瘫男性患者资料,患者留置尿管,尿动力学检查显示膀胱容量约200 ml,存在逼尿肌反射亢进,逼尿肌压力达90 cm H2O,膀胱顺应性降低,约为15 ml/cm H2O.气管插管全麻后行骶神经前根电刺激仪植入及骶神经后根切断术.结果 手术顺利,无手术并发症.术后1个月患者使用电刺激器控制排尿、排便良好,术后随访15个月,尿动力学检查显示膀胱容量增加到500 ml,膀胱顺应性正常,>20 ml/cm H2O,膀胱依靠电刺激仪排尿良好.剩余尿30 ml.结论 骶神经前根电刺激技术+骶神经后根切断术对于骶髓以上的脊髓损伤造成的排尿功能障碍有较好的疗效.

  3. 吞钡造影在神经源性吞咽障碍评估中的应用%Value of Barium swallow radioscopy in assessing neurogenic swallowing dysfunction

    Institute of Scientific and Technical Information of China (English)

    齐赛; 张捧玉

    2004-01-01

    目的:探讨吞钡造影在神经源性吞咽障碍评估中的价值.方法:30例患者分别于康复治疗前和康复治疗后行吞钡造影,观察吞咽的动态过程及其障碍发生的不同时相.结果:吞咽障碍可出现口腔内食物异常滞留、鼻腔逆流、误咽、梨状隐窝食物残留等情况,吞咽康复训练1个月前后比较,上述症状明显改善(P<0.01).结论:吞钡造影评估神经源性吞咽障碍客观、简便、有效.

  4. Use-dependent loss of active sympathetic neurogenic vasodilation after nitric oxide synthase inhibition in conscious rats. Evidence for the presence of preformed stores of nitric oxide-containing factors

    Science.gov (United States)

    Davisson, R. L.; Shaffer, R. A.; Johnson, A. K.; Lewis, S. J.

    1996-01-01

    In this study, we examined whether air-jet stress-induced active sympathetic hindlimb vasodilation in conscious rats involves the release of preformed stores of nitric oxide-containing factors. We determined the effects of repeated episodes of air-jet stress (six episodes given 5 minutes apart) on mean arterial pressure and vascular resistances in the mesenteric bed and intact and sympathetically denervated hindlimb beds of conscious rats treated with saline or the nitric oxide synthesis inhibitor N omega-nitro-L-arginine methyl ester (L-NAME, 25 mumol/kg IV). In saline-treated rats, air-jet stress produced alerting behavior, minor changes in blood pressure, pronounced mesenteric vaso-constriction, and immediate and marked vasodilation in the sympathetically intact hindlimb but a minor vasodilation in the sympathetically denervated hindlimb. Each air-jet stress produced virtually identical responses. In L-NAME-treated rats, the first air-jet stress produced vasodilator responses in the sympathetically intact and sympathetically denervated hindlimbs that were similar to those in the saline-treated rats. However, each subsequent air-jet stress produced progressively smaller vasodilator responses in the sympathetically intact but not the sympathetically denervated hindlimb. There was no loss of air-jet stress-induced alerting behavior or mesenteric vasoconstriction, suggesting that L-NAME did not interfere with the central processing of the air-jet or the resultant changes in autonomic nerve activity. The progressive diminution of air-jet stress-induced vasodilation in the intact hindlimb of L-NAME-treated rats may be due to the use-dependent depletion of preformed stores of nitric oxide-containing factors that cannot be replenished in the absence of nitric oxide synthesis.

  5. Systematic health education on self-management skills of patients with neurogenic bladder%系统健康教育对神经源性膀胱患者自我管理能力的影响

    Institute of Scientific and Technical Information of China (English)

    沈航明; 楼敏; 宋立德

    2013-01-01

    目的 探讨系统健康教育对神经源性膀胱患者自我管理能力的影响.方法 86例神经源性膀胱患者随机分为干预组和对照组各43例,分别进行系统健康教育和常规健康教育.结果干预组健康教育后膀胱类型、临床症状、并发症及其处理、自我管理内容、排尿训练方法、残余尿评估、间歇性导尿知识掌握程度及总分显著高于对照组(P < 0.01).干预组出院时及出院1、3个月自我管理能力及得分亦显著高于对照组(P < 0.05).干预组出院前及出院3个月生活质量5个维度均显著高于对照组(P < 0.05).结论 系统健康教育能显著提高神经源性膀胱患者对疾病、自我管理知识的掌握及自我管理能力,改善患者生活质量.

  6. 糖尿病神经源性膀胱临床常用治疗方法疗效研究%Study to treatment effect of clinical useful method about diabetie neurogenic blader

    Institute of Scientific and Technical Information of China (English)

    范可军; 邓丽娜

    2008-01-01

    Objective The study about comparison of the used treatments,to identify the best clinical treat-ment of diabetic neurogenie bladder.Methods 120 in-patients or out-patients with type 2 diabetes ale randomly di-vided into four groups.On the basis ofthe combined treatment,3 groups of A,B and C are given vitamin B12,B and C group are added respectively cisapride or neostigmine,D group are given methycobal.Results Before and after con-trast,the effects of four groups ale significant,but the effects of B,C and D group ale early and very significant;inter-group differences in contrast,between B,C,D group and A group is significant;between B,C and A group is signifi-cant;between B and C group is no significant.Conclusion The effect of neostigmine or cisapride and vitamin jointly can signifiCalltly reduce tlle DNB patients'residual urine in bladder and urinary retention.the effect is better than a simple application of vitamin or mecobalamin;For DNB milds,as appropriate,can use the treatment of mecobalamin.%目的 将常用治疗方法进行比较研究,以期找出糖尿病神经源性膀胱的临床最佳治疗方案.方法 将住院及门诊2型糖尿病患者120例随机分为四组,在综合治疗基础上A、B、C三组均予维生素B12治疗,B组、C组分别加用西沙比利、溴吡斯的明,D组予羟钴胺治疗.结果 治疗前后对比,四组疗效均显著,但B、C、D显效早且疗效非常显著;组间差异对比,B、C、D组与A组相比差异显著,B、C组与A组相比差异显著,B、C组疗效无显著差异.结论 溴吡斯的明、西沙比利联合维生素治疗的可显著改善DNB残余尿增多及尿潴留,疗效优于单纯应用维生素B12及羟钴胺;DNB轻症,可酌情使用羟钴胺治疗.

  7. Fluoroquinolone's effect on growth of human chondrocytes and chondrosarcomas. In vitro and in vivo correlation

    DEFF Research Database (Denmark)

    Multhaupt, H A; Alvarez, J C; Rafferty, P A;

    2001-01-01

    Clinical and in vitro studies have demonstrated that fluoroquinolones are toxic to chondrocytes; however, the exact mechanism of fluoroquinolone arthropathy is unknown. We investigated the toxicity of ciprofloxacin on normal cartilage and on cartilaginous tumors. Normal human cartilage, enchondroma...

  8. Ultrasound and psoriatic arthritis – Review of the literature and general considerations

    OpenAIRE

    Solivetti, F.M.; Andreoli, G.M.; Bacaro, D.

    2007-01-01

    The authors review the recent literature on the use of ultrasonography in psoriatic arthropathy. The results are discussed in light of the authors' experience and with reference to technological advances and processes.

  9. Evolution of the Imaging Tests in Hemophilia with Emphasis on Radiography and Magnetic Resonance Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kilcoyne, R.F. [Univ. of Colorado Health Sciences Center, Denver, CO (United States). Dept. of Radiology; Lundin, B.; Pettersson, H. [Univ. Hospital of Lund (Sweden). Dept. of Radiology

    2006-04-15

    Even before the discovery of X-rays in 1895 attempts were being made to classify the joint destruction that occurs in hemophilic arthropathy. The advent of radiography added impetus to the search for the optimum classification system. Subsequent attempts have included advanced imaging methods, especially magnetic resonance imaging (MRI). Because of its high spatial resolution and ability to visualize soft tissue abnormalities, MRI is ideally suited as the best way to classify arthropathy. A literature search was carried out to document and list all the imaging methods for hemophilic arthropathy that have been published up to the present. All published classification systems are discussed and listed in tables. MRI has superior imaging capability and will probably become the most important modality for radiological classification of hemophilic arthropathy in the future.

  10. Myhre and LAPS syndromes : clinical and molecular review of 32 patients

    NARCIS (Netherlands)

    Michot, Caroline; Le Goff, Carine; Mahaut, Clementine; Afenjar, Alexandra; Brooks, Alice S.; Campeau, Philippe M.; Destree, Anne; Di Rocco, Maja; Donnai, Dian; Hennekam, Raoul; Heron, Delphine; Jacquemont, Sebastien; Kannu, Peter; Lin, Angela E.; Manouvrier-Hanu, Sylvie; Mansour, Sahar; Marlin, Sandrine; McGowan, Ruth; Murphy, Helen; Raas-Rothschild, Annick; Rio, Marlene; Simon, Marleen; Stolte-Dijkstra, Irene; Stone, James R.; Sznajer, Yves; Tolmie, John; Touraine, Renaud; van den Ende, Jenneke; Van der Aa, Nathalie; van Essen, Ton; Verloes, Alain; Munnich, Arnold; Cormier-Daire, Valerie

    2014-01-01

    Myhre syndrome is characterized by short stature, brachydactyly, facial features, pseudomuscular hypertrophy, joint limitation and hearing loss. We identified SMAD4 mutations as the cause of Myhre syndrome. SMAD4 mutations have also been identified in laryngotracheal stenosis, arthropathy, prognathi

  11. Reverse Shoulder Arthroplasty

    Medline Plus

    Full Text Available ... for sort of common cuff arthroplasty in an elderly thin patient where the head is already rising ... cement this case, because in the typical osteoporotic elderly patient with cuff arthropathy, we would do a ...

  12. Radiology of extra-articular psoriatic osteoarthritis

    Energy Technology Data Exchange (ETDEWEB)

    Chlud, K.

    1981-08-05

    On the basis of the case history of a female patient who had manifest psoriasisis of the skin and psoriatic arthropathy for 10 years, ossifying periostosis in the region of the femural trochanter without manifest clinical symptoms is diagnosed.

  13. Pseudoseptic pseudogout in progressive pseudorheumatoid arthritis of childhood.

    OpenAIRE

    Bradley, J D

    1987-01-01

    Progressive pseudorheumatoid arthritis of childhood is an uncommon arthropathy of unknown aetiology, which is related to spondyloepiphyseal dysplasia tarda. Previous reports have noted the absence of joint inflammation in this disease. An adult is described here with this arthropathy, who developed episodic acute inflammatory arthritis that mimicked septic arthritis, but proved to be pseudogout. The relation between pseudogout and progressive pseudorheumatoid arthritis of childhood is discussed.

  14. Association between human parvovirus B19 infection and arthritis.

    OpenAIRE

    Cassinotti, P; Bas, S; Siegl, G; Vischer, T L

    1995-01-01

    OBJECTIVE--To gain information concerning the association between parvovirus B19 infection and arthritis. METHODS--Blood or synovial fluid, or both, from a total of 77 adult patients with various arthropathies (rheumatoid arthritis 13; mechanical arthropathies 11; crystal induced arthritis 13; idiopathic mono/oligoarthritis 25; suspicion of viral arthritis 15) were tested for the presence of the viral genome and anti-B19 antibodies. B19 DNA in blood and synovial fluid was investigated by nest...

  15. Fluid collections and juxta-articular cystic lesions of the shoulder: spectrum of MRI findings

    Energy Technology Data Exchange (ETDEWEB)

    Mellado, J.M.; Salvado, E.; Camins, A.; Ramos, A.; Sauri, A. [Institut de Diagnostic per la Imatge, Hospital Joan XXIII, Tarragona (Spain); Merino, X. [Institut de Diagnostic per la Imatge, Hospital Vall' Ebron, Barcelona (Spain); Calmet, J. [Orthopaedic Surgery, Hospital Joan XXIII, Carrer Doctor Mallafre Guasch, Tarragona (Spain)

    2002-03-01

    The MR imaging features of fluid collections and juxta-articular cystic lesions of the shoulder are discussed, with special focus on those related to subacromial impingement and rotator cuff tears. Other more unusual fluid collections and cystic lesions are described, including rice-bodies bursitis, idiopathic synovial osteochondromatosis, dialysis-related amyloid arthropathy, hemophilic arthropathy, infectious conditions, non-infectious inflammatory arthritis, and paralabral cysts. (orig.)

  16. Inflammatory bowel disease-associated spondyloarthropathies

    Institute of Scientific and Technical Information of China (English)

    Walter Fries

    2009-01-01

    This issue presents a symposium held in Messina talking about inflammatory bowel disease (IBD) and associated spondyloarthropathies. The topic covers epidemiology and clinical manifestations of IBD-related arthropathies,common genetic and immunologic features, combined therapies for gut and joint inflammation, and future biologic therapies etc. I believe this series of articles will deeply facilitate understanding of and the approach to IBD and associated arthropathies.

  17. Microcirculation of the juvenile knee in chronic arthritis

    DEFF Research Database (Denmark)

    Bünger, Cody; Bülow, J; Tøndevold, E;

    1986-01-01

    In order to investigate pathogenetic factors in growth abnormalities of the knee in hemophilic arthropathy and juvenile rheumatoid arthritis, the hemodynamic changes of the knee following chronic synovial inflammation and elevated joint pressure were studied in puppies. Unilateral arthritis....... The growth plates formed borders for the extension of these changes. The increased permeability and surface area between blood and bone in arthritis may accelerate the resorption and subsequent destruction of subchondral bone in chronic arthropathies of the juvenile knee....

  18. Osteoarthropathy in dialysis amyloidosis

    International Nuclear Information System (INIS)

    Many long-term (>60 months) hemodialysis patients develop a severe osteoarticular disease, called 'dialysis arthropathy', which is characterized by the deposition in bone and synovia of a new type of amyloid made mainly of β2-microglobulin. In the present study, 31 patients (17 males, 14 females; age 54.1±13 years) undergoing chronic hemodialysis arthropathy by means of clinics and of radiological investigations (conventional radiography and computed tomography). Sixteen patients (51.6%) had radiographic evidence of dialysis arthropathy: geodes (shoulders, 12 cases; wrists, 11; hips, 2; knees, 2) and/or destructive arthropathies (cervical spine, 13 cases; dorsolumbar spine, 2; hands, 2; hips, 1). Within 24 months, these lesions were found to progress slowly in the majoriry of cases. In the diagnostic process, CT should be employed in the study of spine, shoulders and hips when the lesions have not been sufficiently demonstrated by conventional radiography in the presence of evident clinical signs. Patients with dialysis arthropathy had undergone dialysis for longer periods than those without it (p<0.005) and showed a significantly higher incidence of both carpal tunnel syndrome (p<0.0005) and shoulder pain (p<0.005). Our findings confirm the high incidence and clinical importance of dialysis arthropathy in long-term hemodialysis patients end the value of diagnostic imaging in screening such patients for those lesions

  19. Non-surgical management of urinary incontinence in children

    Directory of Open Access Journals (Sweden)

    Barry Duel

    2009-01-01

    Full Text Available Urinary incontinence and neurogenic bladder are common in children, and can be difficult to treat. This themed issue includes contributions by experts in the management of these disorders. Dr. John Kryger discusses the nonsurgical management of neurogenic bladder in children with spina bifida. Drs. Lori Dyer and Israel Franco summarize the literature and their experience with the use of botulinum toxin in neurogenic and non-neurogenic incontinence in children. Dr. Paul Austin summarizes the use of alpha-adrenergic blockers. These drugs are primarily used to treat bladder outlet obstruction due to prostatic hyperplasia, but show great promise in the treatment of dysfunctional voiding in children.

  20. Non-surgical management of urinary incontinence in children.

    Science.gov (United States)

    Duel, Barry

    2009-01-01

    Urinary incontinence and neurogenic bladder are common in children, and can be difficult to treat. This themed issue includes contributions by experts in the management of these disorders. Dr. John Kryger discusses the nonsurgical management of neurogenic bladder in children with spina bifida. Drs. Lori Dyer and Israel Franco summarize the literature and their experience with the use of botulinum toxin in neurogenic and non-neurogenic incontinence in children. Dr. Paul Austin summarizes the use of alpha-adrenergic blockers. These drugs are primarily used to treat bladder outlet obstruction due to prostatic hyperplasia, but show great promise in the treatment of dysfunctional voiding in children. PMID:19936567