Congenital scalp defect with thrombosis of the sagittal sinus. Case report.

A case report of a congenital scalp defect, associated with thrombosis of the superior sagittal sinus, is presented. A thrombectomy of the sinus, followed by skin grafting, was successful in achieving wound closure and a healthy, normal child. We propose that thrombectomy be considered for future similar situations.     

鼻内镜手术联合咪康唑鼻窦内灌注治疗非侵袭性真菌性鼻窦炎的疗效观察

目的探讨鼻内镜手术联合咪康唑鼻窦内灌注治疗非侵袭性真菌性鼻窦炎的疗效。方法选取住院治疗的非侵袭性真菌性鼻窦炎患者68例,随机将其分为观察组和对照组,每组34例。对照组患者采用鼻内镜手术治疗非侵袭性真菌性鼻窦炎,观察组患者在对照组治疗基础上予以咪康唑鼻窦内灌注。观察并记录两组患者治疗1个月后的临床疗效及药物不良反应,并比较治疗后随访半年与1年复发率。结果治疗1个月后,观察组患者临床总有效率明显高于对照组(χ2=4.22,P0.05)。观察组治疗中有2例患者出现不良反应,症状较轻。治疗后随访半年与1年,观察组患者的复发率分别为3.13%和9.38%,均明显低于对照组的26.92%和34.62%(χ2=4.98或5.57,P0.05)。结论鼻内镜手术联合咪康唑鼻窦内灌注治疗非侵袭性真菌性鼻窦炎的疗效明显优于单纯的鼻内镜手术治疗,安全性较好,且其中远期疗效较好,能减少其术后复发,具有预防其病情复发作用。     

Needle tract sinus following aspiration biopsy of papillary thyroid carcinoma: a case report

BACKGROUND: Fine needle aspiration biopsy (FNAB) of the thyroid is a simple and safe investigation. Dissemination of malignant cells during FNA for papillary thyroid carcinoma is extremely uncommon. CASE: We report a 49-year-old woman who presented with a multicystic goiter and palpable cervical lymph nodes. Three sessions of FNAB (a total of 12 needle passes) from a complex cyst overlying the thyroid isthmus using a 22-gauge needle failed to reveal malignant cells. Following the FNAs she developed a persistent discharging sinus at the needle insertion site. Exploration of the neck and histopathologic examination confirmed a well-differentiated papillary thyroid carcinoma infiltrating the skin and strap muscles at a single focus. Debulking surgery with adjuvant radiotherapy had a satisfactory outcome in our patient. CONCLUSION: Skin sinus formation might have been prevented in our case by using a needle with a caliber < 22 gauge and avoiding multiple sessions of aspiration of the same thyroid nodule.     

Elicitation of the oculocardiac reflex during endoscopic forehead lift surgery.

Elicitation of the oculocardiac reflex is a well-documented phenomenon encountered during ophthalmologic surgical procedures. Familiarity with and prompt recognition of this entity has significantly reduced the morbidity associated with it; however, potentially lethal arrhythmias and cardiac arrest still occur. We report elicitation of the reflex during manipulation of the supraorbital nerve during endoscopic forehead lift surgery. To our knowledge this is the first case of elicitation of the oculocardiac reflex reported during endoscopic forehead lift surgery.     

Differential regulation of metallothionein-I and metallothionein-II mRNA expression in the rat brain following traumatic brain injury

In this study, we investigated the expression of metallothionein (MT)-I and MT-II in the rat brain following traumatic brain injury (TBI). In the early stage, significant induction of MT-I and MT-II were observed in various regions including ventricle walls, pia mater, and dentate gyrus. At 12-24 h after TBI, strong induction of MT-I mRNA was observed in cerebral cortical layer II/III, amygdala, and piriform cortex where neurons reside. On the other hand, MT-II appeared to be expressed mainly in glial cells localized in the cerebral cortex and hippocampal formation. Three days after TBI, MTs were observed in the vimentin-positive astrocytes in the penumbra as revealed by double immunohistochemistry. The differences in expression of MT-I and MT-II in different brain regions and cell types (neuron vs. glial cells) suggests that multiple regulatory mechanisms are involved in the control of MT expression following brain injury.     

Proteomic analysis of the anterior cingulate cortex in the major psychiatric disorders: Evidence for disease-associated changes

Abnormalities of the anterior cingulate cortex have previously been described in schizophrenia, major depressive disorder and bipolar disorder. In this study 2-DE was performed followed by mass spectrometric sequencing to identify disease-specific protein changes within the anterior cingulate cortex in these psychiatric disorders. The 2-DE system comprised IPGs 4-7 and 6-9 in the first, IEF dimension and SDS-PAGE in the second dimension. Resultant protein spots were compared between control and disease groups. Statistical analysis indicated that 35 spots were differentially expressed in one or more groups. Proteins comprising 26 of these spots were identified by mass spectroscopy. These represented 19 distinct proteins; aconitate hydratase, malate dehydrogenase, fructose bisphosphate aldolase A, ATP synthase, succinyl CoA ketoacid transferase, carbonic anhydrase, alpha- and beta-tubulin, dihydropyrimidinase-related protein-1 and -2, neuronal protein 25, trypsin precursor, glutamate dehydrogenase, glutamine synthetase, sorcin, vacuolar ATPase, creatine kinase, albumin and guanine nucleotide binding protein beta subunit. All but three of these proteins have previously been associated with the major psychiatric disorders. These findings provide support for the view that cytoskeletal and mitochondrial dysfunction are important components of the neuropathology of the major psychiatric disorders.     

Acoustic thermometry of the patient brain with traumatic brain injury

Non-invasive deep brain acoustic thermometry is carried out for two patients at Burdenko Neurosurgery Institute. This method is based on the measurements of the own thermal acoustic radiation of the investigated object. These two patients have got the brain injury. Some of their skull bones are absent. Infrared thermometry was also used to measure the surface temperature of the forehead skin. On the basis of the experimental data the temperatures deep within the brain were reconstructed. The values for the two patients are equal to 37.3 ± 0.7 and 37.0 ± 0.3°C.     

Mitochondrial respiratory chain and creatine kinase activities following trauma brain injury in brain of mice preconditioned with N-methyl-d-aspartate

Traumatic brain injury (TBI) induces glutamatergic excitotoxicity through N-methyl-d-aspartate (NMDA) receptors, affecting the integrity of the mitochondrial membrane. Studies have pointed to mitochondria as the master organelle in the preconditioning-triggered endogenous neuroprotective response. The present study is aimed at understanding energy metabolism in the brains of mice after preconditioning with NMDA and TBI. For this purpose, male albino CF-1 mice were pre-treated with NMDA (75 mg/kg) and subjected to brain trauma. Mitochondrial respiratory chain and creatine kinase activities were assessed at 6 or 24 h after trauma. The mice preconditioned and subjected to TBI exhibited augmented activities of complexes II and IV in the cerebral cortex and/or cerebellum. Creatine kinase activity was also augmented in the cerebral cortex after 24 h. We suggest that even though NMDA preconditioning and TBI have similar effects on enzyme activities, each manage their response via opposite mechanisms because the protective effects of preconditioning are unambiguous. In conclusion, NMDA preconditioning induces protection via an increase of enzymes in the mitochondria.     

Carotid artery injury with cerebral infarction following head and neck blunt trauma: report of a case

Blunt injury to the carotid artery is rare but may produce a devastating outcome with longterm morbidity. Initial recognition by clinicians is often difficult because of the diverse clinical manifestations, the delay in presentation of symptoms, and the associated multi-organ system injuries that accompany carotid injury. Early diagnosis and successful management of traumatic carotid artery injury require a high index of clinical suspicion. We report herein a 20-year-old male victim of internal carotid artery injury induced by a motorcycle accident, who initially presented with a clear consciousness and had normal computed tomogram (CT) of brain. Two days after injury, the patient suffered from left hemiplegia and coma. The follow-up brain CT showed acute infarction of right cerebrum and severe cerebral edema. Emergency craniotomy for brain decompression and anticoagulation therapy was carried out. After a three-month treatment, he was discharged and underwent regular follow-up in the outpatient department. Six months later, the patient had intact awareness but remained in a left-sided hemiparetic state.     

Electrical activity of the limbic structures of the dog brain during simultaneous stimulation of the cingulate gyrus and hypothalamus]

Simultaneous electrical stimulation of the anterior part of the cingulate gyrus and the anterior-lateral part of the hypothalamus in the dog brought about EEG synchronization in the limbic system structures and increased correlation coefficients between them. The animal's behaviour exhibited positive emotionally reactions (licking, sniffing, wagging the tail), attended with slowing of the heart rate. The indicated changes directly depend on the degree of emotional stress (the changes are more pronounced in hungry than in sated animals). Simultaneous stimulation of the anterior part of the cingulate gyrus and the anterior-lateral part of the hypothalamus apparently activates a system which reduces the level of emotional stress.     

Entrapment of an air gun pellet between the thyroid cartilage and the lining mucosa in a patient with a penetrating neck injury: a case report

ABSTRACT: INTRODUCTION: Air guns, either modern or traditional models, are powerful weapons that are capable ofcausing serious or life-threatening injuries. CASE PRESENTATION: Here, we present a case of an air gun pellet injury, with the pellet trapped between the thyroidcartilage and the lining mucosa of a 58-year-old Iranian man. CONCLUSION: Entrapment of air gun pellet between thyroid cartilage and the lining mucosa, as presented inour case, may cause diagnostic challenges through the clinical presentation of slightodynophagia.     

Effects of delta-sleep-inducing peptide during ischemic injury of the rat brain

An anti-ischemic effect of the delta-sleep-inducing peptide (DSIP) was found in rats. The DSIP effect was more obvious than that of the MK-801. The data obtained is discussed considering a possible use of the DSIP for brain stroke prophylaxis.