• 文章类型: Journal Article
    神经核内的运动神经元(MN)支配喉的骨骼肌,咽部,还有食道.这些肌肉在发声和吞咽过程中被激活,并且必须与几种呼吸和其他行为相协调。尽管有许多研究评估了MNs在歧义核内的投影和方向,没有关于居住在契约中的MNs树突状的定量信息,和半紧凑/松散的核构造。.
    在雌性和雄性Fischer344只大鼠中,我们使用Nissl染色评估MN数,使用高尔基体-Cox浸渍法,对Nissl横向切片(15μm)进行明场成像,以从立体上评估致密和半紧密/松散地层中的模糊核MN的数量。在3D中追踪了Bomiguus核内高尔基体浸渍的神经元的假共焦成像(在180μm处横向剖切),以确定树突状聚集。
    我们发现,与半紧凑/松散的地层相比,致密体内的MNs更多。树枝状长度,复杂性,半收缩/松散地层的MNs中,凸包表面积最大,紧凑的地层MN较小。来自两个区域的MNs都大于在歧义核内重建的非MNs。
    在饮食中添加HBLS可能是改善马健康的潜在有效策略。
    UNASSIGNED: Motor neurons (MNs) within the nucleus ambiguus innervate the skeletal muscles of the larynx, pharynx, and oesophagus. These muscles are activated during vocalisation and swallowing and must be coordinated with several respiratory and other behaviours. Despite many studies evaluating the projections and orientation of MNs within the nucleus ambiguus, there is no quantitative information regarding the dendritic arbours of MNs residing in the compact, and semicompact/loose formations of the nucleus ambiguus..
    UNASSIGNED: In female and male Fischer 344 rats, we evaluated MN number using Nissl staining, and MN and non-MN dendritic morphology using Golgi-Cox impregnation Brightfield imaging of transverse Nissl sections (15 μm) were taken to stereologically assess the number of nucleus ambiguus MNs within the compact and semicompact/loose formations. Pseudo-confocal imaging of Golgi-impregnated neurons within the nucleus ambiguus (sectioned transversely at 180 μm) was traced in 3D to determine dendritic arbourisation.
    UNASSIGNED: We found a greater abundance of MNs within the compact than the semicompact/loose formations. Dendritic lengths, complexity, and convex hull surface areas were greatest in MNs of the semicompact/loose formation, with compact formation MNs being smaller. MNs from both regions were larger than non-MNs reconstructed within the nucleus ambiguus.
    UNASSIGNED: Adding HBLS to the diet could be a potentially effective strategy to improve horses\' health.
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  • 文章类型: Journal Article
    这项研究使用预处理的听觉脑干反应(ABR)图像数据评估了几种卷积神经网络(CNN)模型对患者听力损失进行分类的功效。具体来说,我们采用了六种CNN架构-VGG16,VGG19,DenseNet121,DenseNet-201,AlexNet,和InceptionV3-区分听力损失患者和听力正常患者。使用包含7990个预处理的ABR图像的数据集来评估这些模型的性能和准确性。对每个模型进行了系统测试,以确定其准确分类听力损失的能力。模型的比较分析侧重于准确性和计算效率的度量。结果表明,AlexNet模型表现出优异的性能,达到95.93%的精度。这项研究的结果表明,深度学习模型,特别是在这种情况下的AlexNet,具有使用ABR图数据自动诊断听力损失的巨大潜力。未来的工作将旨在完善这些模型,以提高其诊断准确性和效率。促进其在临床环境中的实际应用。
    This study evaluates the efficacy of several Convolutional Neural Network (CNN) models for the classification of hearing loss in patients using preprocessed auditory brainstem response (ABR) image data. Specifically, we employed six CNN architectures-VGG16, VGG19, DenseNet121, DenseNet-201, AlexNet, and InceptionV3-to differentiate between patients with hearing loss and those with normal hearing. A dataset comprising 7990 preprocessed ABR images was utilized to assess the performance and accuracy of these models. Each model was systematically tested to determine its capability to accurately classify hearing loss. A comparative analysis of the models focused on metrics of accuracy and computational efficiency. The results indicated that the AlexNet model exhibited superior performance, achieving an accuracy of 95.93%. The findings from this research suggest that deep learning models, particularly AlexNet in this instance, hold significant potential for automating the diagnosis of hearing loss using ABR graph data. Future work will aim to refine these models to enhance their diagnostic accuracy and efficiency, fostering their practical application in clinical settings.
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  • 文章类型: Journal Article
    所有陆生脊椎动物的生命都必须从胚胎环境中的水生气体交换过渡到出生时的空中或肺呼吸。除了能够呼吸空气,新生儿必须具有功能性感觉反馈系统以维持酸碱平衡。脑干中的呼吸神经元充当pH传感器,可以调节呼吸以调节全身pH。在斑马雀(Taeniopygiaguttata)的胚胎期,与呼吸相关的运动输出的中心pH敏感性发展。由于氯离子在电化学稳定性和发育可塑性中的关键作用,我们测试了氯化物在中心pH敏感性发展中的作用。我们阻断了γ-氨基丁酸-A受体和阳离子-氯化物共转运,从而巧妙地调节了低pH对早期呼吸生物节律的影响。Further,无氯人工脑脊液改变了呼吸生物节律的模式和时间,并阻断了E12-14脑干酸中毒的刺激作用。早期和中期胚胎在低pH治疗期间表现出脑干运动输出的反弹可塑性,被无氯化物溶液消除。结果表明,氯化物调节斑马雀胚胎脑干的低pH敏感性和回弹可塑性,但是需要进行工作来确定在酸碱干扰期间控制功能性氯化物平衡的细胞和回路机制。
    All terrestrial vertebrate life must transition from aquatic gas exchange in the embryonic environment to aerial or pulmonary respiration at birth. In addition to being able to breathe air, neonates must possess functional sensory feedback systems for maintaining acid-base balance. Respiratory neurons in the brainstem act as pH sensors that can adjust breathing to regulate systemic pH. The central pH sensitivity of breathing-related motor output develops over the embryonic period in the zebra finch (Taeniopygia guttata). Due to the key role of chloride ions in electrochemical stability and developmental plasticity, we tested chloride\'s role in the development of central pH sensitivity. We blocked gamma-aminobutyric acid-A receptors and cation-chloride cotransport that subtly modulated the low-pH effects on early breathing biorhythms. Further, chloride-free artificial cerebrospinal fluid altered the pattern and timing of breathing biorhythms and blocked the stimulating effect of acidosis in E12-14 brainstems. Early and middle stage embryos exhibited rebound plasticity in brainstem motor outputs during low-pH treatment, which was eliminated by chloride-free solution. Results show that chloride modulates low-pH sensitivity and rebound plasticity in the zebra finch embryonic brainstem, but work is needed to determine the cellular and circuit mechanisms that control functional chloride balance during acid-base disturbances.
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  • 文章类型: Letter
    暂无摘要。
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  • 文章类型: Journal Article
    目的:由于证据有限,鼻脑脊液(CSF)泄漏的围手术期处理不是自愿的。这项研究的主要目的是确定国际专家围手术期治疗鼻内镜下脑脊液漏修复的关键因素。
    方法:一项60项调查问卷收集了耳鼻喉科外科医师和神经外科医师国际学会成员对鼻腔填塞的意见,术后指示,抗生素预防,和脑脊液容量耗尽。
    结果:调查有153名受访者(124名耳鼻喉科医师和29名神经外科医师)。85%(130/151)的受访者建议前颅底脑脊液漏延长的静息位置,主要在福勒的位置(72%(110/153))。85%(130/153)的受访者使用鼻塞;33.3%(51/153)的受访者使用鼻塞来稳定重建,和22.2%(34/153)防止出血。在44.4%的病例(68/153)中,通常在48小时后将其清除。在CSF泄漏复发的情况下,有47.1%(72/153)的受访者认为CSF耗尽,在颅内压升高的情况下,有34.6%(53/153)的受访者认为CSF耗尽。所有受访者都向患者提供了具体的术后指导,包括驾驶,跑步,游泳,潜水限制和飞行限制。在亚组分析中,耳鼻喉科外科医生比神经外科医生更经常推荐休息姿势(71%vs.37.9%;p=0.0008),开了更多的抗生素(82.3%vs.21.4%;p<0.0001)。
    结论:尽管CSF闭合后的术后管理仍然具有挑战性,但尚未成文,这项国际调查揭示了一些关于休息位置和术后活动限制的共识。必须进行前瞻性临床研究以评估其效率。
    OBJECTIVE: Peri-operative management of nasal cerebrospinal fluid (CSF) leaks is not consensual due to limited evidence. The main aim of this study was to identify key factors in peri-operative management of endoscopic endonasal CSF leak repair among international experts.
    METHODS: A 60-item survey questionnaire collected opinions of members of international learned societies of ENT surgeons and neurosurgeons on nasal packing, post-operative instructions, antibiotic prophylaxis, and CSF volume depletion.
    RESULTS: The survey had 153 respondents (124 otorhinolaryngologists and 29 neurosurgeons). A resting position was recommended by 85% (130/151) of respondents for extended CSF leak of the anterior skull base, mainly in Fowler\'s position (72% (110/153)). Nasal packing was used by 85% (130/153) of respondents; 33.3% (51/153) used it to stabilize the reconstruction, and 22.2% (34/153) to prevent bleeding. It was usually removed after 48 h in 44.4% of cases (68/153). CSF depletion was considered by 47.1% (72/153) of respondents in case of CSF leak recurrence and by 34.6% (53/153) in cases of increased intracranial pressure. All respondents gave specific postoperative instructions to patients including driving, running, swimming, diving restrictions and flighting restrictions. In subgroup analysis, ENT surgeons more often recommended a resting position than neurosurgeons (71% vs. 37.9% ; p = 0.0008) and prescribed more antibiotics (82.3% vs. 21.4% ; p < 0.0001).
    CONCLUSIONS: Although postoperative management after CSF closure remains challenging and not codified, this international survey revealed some points of consensus concerning resting position and restriction of post-operative activities. Prospective clinical studies must be undertaken to evaluate their efficiency.
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  • 文章类型: Journal Article
    我们在这里报告了非常罕见的自发性心室内张力性气颅病例。该病例涉及一名40岁的患者,该患者有松果体区肿瘤病史,并通过多脑室腹膜分流术治疗继发性脑积水。他因为不寻常的头痛出现在急诊室,恶心,和视觉损失。此外,他报告了几个星期的轻微鼻漏。最初的脑部CT扫描显示自发性脑室内张力性气血。没有近期头部外伤的病史,也没有分流系统断开的迹象。补充的放射学评估包括薄层骨CT扫描和放射性同位素池造影,该造影显示骨缺损和同位素渗漏在鼓膜和左颞骨鳞状部分之间的交界处。进行了中颅窝手术以修复骨膜破裂。
    We report here a very rare case of spontaneous intraventricular tension pneumocephalus. This case concerns a 40-year-old patient with a medical history of a tumor of the pineal region and secondary hydrocephalus treated by multiple ventriculoperitoneal shunts. He presented in the emergency room because of unusual headaches, nausea, and visual loss. In addition, he reported slight rhinorrhea for a few weeks. The initial brain CT scan revealed a spontaneous intraventricular tension pneumocephalus. There was no history of recent head trauma and no sign of disconnection of the shunt system. A complementary radiological assessment included a thin-slice bone CT scan and a radioisotope cisternography that revealed an osseous defect and an isotope leakage at the junction between the tegmen tympani and the squamous part of the left temporal bone. A middle cranial fossa surgery was performed to repair the osteo-meningeal breach.
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  • 文章类型: Journal Article
    术后脑脊液漏是经蝶窦入路(TSA)和扩大鼻内入路(EEA)治疗蝶鞍和腹侧颅底病变后的主要发病原因。关于肥胖(BMI≥30)是否是这种并发症的危险因素,文献中有相互矛盾的报道。我们旨在评估作为前瞻性多中心队列研究的一部分收集的数据,以解决这个问题。
    对颅骨基础鼻内介入后的脑脊液鼻孔(CSF鼻孔)研究数据库进行了审查,并将患者分为肥胖和非肥胖队列。患者人口统计数据,基础病理学,分析了术中发现和颅底修复技术。
    对726例患者进行了TSA,其中210人肥胖,516人不肥胖。肥胖人群术后脑脊液漏出率为11/210(5%),与非肥胖队列中的17/516(3%)相比,差异无统计学意义(χ2=1.520,p=0.217)。对140名患者进行了EEA,其中28人肥胖,112人非肥胖。肥胖人群术后脑脊液漏出率为2/28(7%),这与非肥胖队列8/112(7%)Fisher精确检验中观察到的比率相同,p=1.000)。在调整机构间差异和术后CSF泄漏的基线风险后,这些结果仍然存在。
    TSA和EEA后的CSF泄漏率,结合现代颅底修复技术,被发现在肥胖和非肥胖患者中都很低。然而,由于术后脑脊液渗漏率低,我们无法完全排除肥胖对该并发症风险的微小贡献.
    UNASSIGNED: Post-operative CSF leak is the major source of morbidity following transsphenoidal approaches (TSA) and expanded endonasal approaches (EEA) to lesions of the sella turcica and the ventral skull base. There are conflicting reports in the literature as to whether obesity (BMI ≥30) is a risk factor for this complication. We aimed to evaluate data collected as part of prospective multi-centre cohort study to address this question.
    UNASSIGNED: The CRANIAL (CSF Rhinorrhoea After Endonasal Intervention to the Skull Base) study database was reviewed and patients were divided into obese and non-obese cohorts. Data on patient demographics, underlying pathology, intra-operative findings and skull base repair techniques were analysed.
    UNASSIGNED: TSA were performed on 726 patients, of whom 210 were obese and 516 were non-obese. The rate of post-operative CSF leak in the obese cohort was 11/210 (5%), compared to 17/516 (3%) in the non-obese cohort, which was not statistically significant (χ2 = 1.520, p=0.217). EEA were performed on 140 patients, of whom 28 were obese and 112 were non-obese. The rate of post-operative CSF leak in the obese cohort was 2/28 (7%), which was identical to the rate observed in the non-obese cohort 8/112 (7%) Fisher\'s Exact Test, p=1.000). These results persisted following adjustment for inter-institutional variation and baseline risk of post-operative CSF leak.
    UNASSIGNED: CSF leak rates following TSA and EEA, in association with modern skull base repair techniques, were found to be low in both obese and non-obese patients. However, due to the low rate of post-operative CSF leak, we were unable to fully exclude a small contributory effect of obesity to the risk of this complication.
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  • 文章类型: Journal Article
    太平洋鲑鱼的中枢神经系统在整个生命中保留了胚胎结构的迹象,并且在大脑的增殖区域中保留了大量的神经上皮神经干细胞(NSC),特别是。然而,对虹鳟鱼的成人神经系统和神经发生研究,Oncorhynchusmykiss,是有限的。这里,我们研究了谷氨酰胺合成酶(GS)的定位,波形蛋白(Vim),和Nestin(Nes),以及在胚胎后时期形成的神经元,标记有doublecoortin(DC),在使用免疫组织化学方法和Western免疫印迹的Oncornchusmykiss成年小脑和脑干的稳态生长条件下。我们观察到波形蛋白(Vim)的分布,nestin(Nes),和谷氨酰胺合成酶(GS),在小脑和鳟鱼脑干的胚胎型(神经上皮细胞)和成体型(放射状神经胶质)的aNSPCs中发现,具有某些特征。成体神经干/祖细胞(aNSPCs)的群体表达GS,Vim,和Nes有不同的形态,本地化,鳟鱼小脑和脑干的簇形成模式,它表示形态和,显然,这些细胞的功能异质性。PCNA的免疫标记显示虹鳟鱼的小脑和脑干中含有增殖细胞的区域与表达Vim的区域一致,Nes,和GS。双重免疫标记揭示了脑干PVZ中神经上皮型细胞中的PCNA/GSPCNA/Vim共表达模式。在脑干边缘区检测到RG中的PCNA/GS共表达。对鳟鱼小脑和脑干中DC分布的免疫组织化学研究结果表明,该标记物在各种细胞群中的高表达水平。这可能表明:(i)成年鳟鱼的小脑和脑干中成年神经元的高产量,(ii)鳟鱼小脑和脑干神经元的高可塑性。我们假设鳟鱼脑中新细胞的来源,以及PVZ和SMZ,含有增殖细胞,可能是含有PCNA阳性和沉默(PCNA阴性)的局部神经源性壁龛,但是表达NSC标记,细胞。表达DC的细胞的鉴定,Vim,并在鳟鱼的IX-X颅神经核中进行了Nes。
    The central nervous system of Pacific salmon retains signs of embryonic structure throughout life and a large number of neuroepithelial neural stem cells (NSCs) in the proliferative areas of the brain, in particular. However, the adult nervous system and neurogenesis studies on rainbow trout, Oncorhynchus mykiss, are limited. Here, we studied the localization of glutamine synthetase (GS), vimentin (Vim), and nestin (Nes), as well as the neurons formed in the postembryonic period, labeled with doublecortin (DC), under conditions of homeostatic growth in adult cerebellum and brainstem of Oncorhynchus mykiss using immunohistochemical methods and Western Immunoblotting. We observed that the distribution of vimentin (Vim), nestin (Nes), and glutamine synthetase (GS), which are found in the aNSPCs of both embryonic types (neuroepithelial cells) and in the adult type (radial glia) in the cerebellum and the brainstem of trout, has certain features. Populations of the adult neural stem/progenitor cells (aNSPCs) expressing GS, Vim, and Nes have different morphologies, localizations, and patterns of cluster formation in the trout cerebellum and brainstem, which indicates the morphological and, obviously, functional heterogeneity of these cells. Immunolabeling of PCNA revealed areas in the cerebellum and brainstem of rainbow trout containing proliferating cells which coincide with areas expressing Vim, Nes, and GS. Double immunolabeling revealed the PCNA/GS PCNA/Vim coexpression patterns in the neuroepithelial-type cells in the PVZ of the brainstem. PCNA/GS coexpression in the RG was detected in the submarginal zone of the brainstem. The results of immunohistochemical study of the DC distribution in the cerebellum and brainstem of trout have showed a high level of expression of this marker in various cell populations. This may indicate: (i) high production of the adult-born neurons in the cerebellum and brainstem of adult trout, (ii) high plasticity of neurons in the cerebellum and brainstem of trout. We assume that the source of new cells in the trout brain, along with PVZ and SMZ, containing proliferating cells, may be local neurogenic niches containing the PCNA-positive and silent (PCNA-negative), but expressing NSC markers, cells. The identification of cells expressing DC, Vim, and Nes in the IX-X cranial nerve nuclei of trout was carried out.
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  • 文章类型: Case Reports
    水通道蛋白-4抗体(AQP4-Ab)是患有称为视神经脊髓炎谱系障碍(NMOSD)的脱髓鞘疾病的患者的诊断标记物。抗Argonaute抗体(AGO-Ab)作为NMOSD和其他自身免疫性疾病之间重叠综合征的潜在生物标志物。在本文中,我们提出了一个成年女性麻木的案例,刺痛,和灼热的感觉在她的手臂和随后的双侧核间眼肌麻痹。脑-颈-胸磁共振成像(MRI)显示,背侧脑干和中脑导水管周围的T2高信号和纵向横贯性脊髓炎,在钆增强的MRI上均匀增强。同时检测AQP4-和AGO-Abs可明确诊断NMOSD与AGO-Abs重叠综合征。患者接受了免疫抑制剂治疗,包括皮质类固醇和免疫球蛋白,并实现了缓解。这个案例突出了一个新的NMOSD表型与AGO-Abs重叠综合征,表现为复发性脑干综合征和纵向广泛脊髓炎,并伴有急性严重神经系统受累。该疾病的有希望的预后可以作为独特的临床特征。对于临床表现有限或不典型的可疑患者,建议广泛筛查针对中枢神经系统自身免疫抗原的抗体。
    Aquaporin-4 antibodies (AQP4-Abs) are a diagnostic marker for patients with a demyelinating disease called neuromyelitis optica spectrum disorder (NMOSD). Anti-Argonaute antibodies (AGO-Abs) present as potential biomarkers of the overlap syndrome between NMOSD and other autoimmune diseases. In this paper, we present the case of an adult woman with numbness, tingling, and burning sensations in her arms and subsequent bilateral internuclear ophthalmoplegia. Brain-cervical-thoracic magnetic resonance imaging (MRI) showed T2 hyperintensities in the dorsal brainstem and around the midbrain aqueduct and longitudinally transverse myelitis with homogeneous enhancement on gadolinium-enhanced MRI. The contemporaneous detection of AQP4- and AGO-Abs led to a definite diagnosis of overlap syndrome of NMOSD with AGO-Abs. The patient was treated with immunosuppressive agents, including corticosteroids and immunoglobulins, and achieved remission. This case highlights a novel phenotype of NMOSD with AGO-Abs overlap syndrome, which presents with relapsing brainstem syndrome and longitudinally extensive myelitis with acute severe neurological involvement. The promising prognosis of the disease could serve as a distinct clinical profile. Broad screening for antibodies against central nervous system autoimmune antigens is recommended in suspected patients with limited or atypical clinical manifestations.
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  • 文章类型: Journal Article
    垂体大腺瘤切除后,颅底缺损伴3级脑脊液(CSF)渗漏是罕见且具有挑战性的。我们提供了具有自然可用的硬和软组织组件的多层闭合的简单样本模型。使用简单的充气Foley导管球向重建部位提供填塞。随访中没有修复失败,并且腔的粘膜盐化良好。在这种方法中完全实现了粘膜和鼻甲的保存,因为没有鼻甲皮瓣凸起或存在大量的原始表面暴露。
    A skull- base defect with grade-3 cerebrospinal fluid (CSF) leak following a pituitary macroadenoma removal is rare and challenging. We provide a simple sample model of multilayer closure with naturally available hard and soft tissue components. Tamponade was provided to the reconstructed site with a simple inflated Foley\'s catheter bulb. There was no repair failure and cavities were well mucosalised on follow-up. Mucosal and turbinate preservation was fully achieved in this method as no turbinate flaps were raised or large raw surface exposure was there.
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