Objective To investigate radiological features of patients with heroin spongiform leukoencephalopathy(HSLE)of different clinical stages and discuss the evolutional characteristics of the disease.Methods Thirty two patients with HSLE underwent precontrast MRI and postcontrast MRI.The history of addiction,clinical presentations,and brain MRI were analyzed and summarized according to the patient's clinical staging.There are 6 cases in Ⅰ stage,21 cases in Ⅱ stage,5 cases in Ⅲ stage.Results All patients had history of heroin vapor inhalation.Most of the cases developed subacute cerebellar impairment in earlier period.Brain MRI revealed symmetrical lesion within bilateral cerebellum in all patients.Splenium of the corpus callosum,posterior limb of the internal capsule,deep white matter of the occipital and parietal lobes,were gradually involved with progressive deterioration of HSLE.The brain stem and deep white matter of the frontal and temporal lobes were involved in some cases.Conclusions The history of heated heroin vapor inhalation was the prerequisite for the diagnosis of HSLE.Brain MRI presented the characteristic lesion and its evolution of HSLE.Brain MRI was very important for accurate diagnosis and helpful to judge the clinical stages according to the involved brain region.

Objective To analyze the effectiveness of chronic disease management among suburb residents to secure an optimal health management model. Methods Since 2002, physical examinations had been conducted for rural residents aged≥40. Hypertensive patients detected on health check received medical evaluation and risk factor intervention. Results The incidence of high blood pressure decreased from 26.57% in 2002 to 11.99% in 2007-2008. The mortality of cerebrovascular disease declined from 68.00% to 5.26%. The incidence, disability rate, and death rate of hypertension related-stroke were also significantly reduced. Conclusion Primary healthcare center-based chronic disease screening, along with the health management network, can largely decrease the incidence, disability rate, and mortality of stroke associated with high blood pressure.

OBJECTIVETo test the reliability of quantitative neurological tests in evaluating the neurological deficits in rat models of cerebral ischemia.

METHODSForty male SD rats (7 to 9 weeks old) were subjected to transient (1 h) middle cerebral artery occlusion (MCAO) to induce cerebral infarction and 9 received sham operation only. The motor and sensory functions of the rats were measured before and 1, 3, 7 and 14 days after MCAO by accelerating rotarod test and modified adhesive removal test. Fourteen days later, the rats were sacrificed for histological examination, and the lesion size was determined by Winroof image analysis. The neurological deficits of the rats with different lesion sizes and at different time points were analyzed.

RESULTSAccording to the infarct size, the rats after MCAO were divided into two subgroups with large lesions [(68.56+/-12.54)%] affecting both the cortical area and basal ganglia and small lesions [(12.45+/-9.06)%] affecting the basal ganglia. Significant differences in the results of modified adhesive removal test and rotarod test were found between the two groups, and a liner relationship was noted between the lesion size and the results of the neurological tests.

CONCLUSIONThe modified quantitative neurological tests can reliably evaluate the severity of the infarction and estimate the infarct size in rats with cerebral infarction.

Animals ; Behavior, Animal ; physiology ; Brain Ischemia ; pathology ; physiopathology ; Infarction, Middle Cerebral Artery ; pathology ; physiopathology ; Male ; Motor Activity ; Neurologic Examination ; Psychomotor Performance ; Rats ; Rats, Sprague-Dawley ; Severity of Illness Index

OBJECTIVETo investigate the correlation between the diffusion anisotropy of the white matter fibers and the cognitive function in patients with leukoaraiosis (LA).

METHODSThirty-one LA patients were enrolled in this study, including 13 with grade LA-1 (mild), 12 with grade LA-2 (moderate) and 6 with grade LA-3 (severe) condition. The control group consisted of 18 subjects who were free of obvious clinical symptoms or had only mild dizziness and headache but with negative history for neural system diseases and in the absence of cognitive dysfunction, brain trauma, positive signs in neurological examinations, or abnormities in MRI examination. The Mini-mental State Examination (MMSE) was applied to evaluate the patients' cognitive function. The LA patients underwent examination with diffusion tensor MR imaging (DTI), and the FA and MD values in the normal-appearing white matter (NAWM) were measured.

RESULTSThe cognitive function of the LA patients tended to decline with the decrease of the MMSE scores, and their scores for time orientation, place orientation and calculation were significantly lower than those of the control group (P<0.05). No significant difference was found in memory, language and comprehensive abilities between the LA and control groups. In LA-1, LA-2 and total LA cases, the FA value in the NAWM was positively, and the MD value inversely, correlated to the cognitive function with correlation coefficients ranging from 0.5 to 0.8 (P<0.05).

CONCLUSIONThe DTI parameters of NAWM region are correlated to the cognitive function of LA patients. DTI is far more sensitive than MRI in evaluating cognitive dysfunction in LA patients.

Aged ; Aged, 80 and over ; Anisotropy ; Case-Control Studies ; Cognition Disorders ; diagnosis ; etiology ; Diffusion Magnetic Resonance Imaging ; methods ; Female ; Humans ; Leukoaraiosis ; complications ; pathology ; Male ; Middle Aged ; Neuropsychological Tests

OBJECTIVETo investigate the nature of white matter lesion and correlation to memory impairment in patients with obstructive sleep apnea syndrome (OSAS) by diffusion tensor imaging ( DTI).

METHODWe conducted a cross-sectional study of 20 middle-aged male people (10 with OSAS and 10 healthy controls) group-matched by age, educational level, and socioeconomic status. DTI was performed on those people with OSAS and on matched controls. Fractional anisotropy(FA) and average diffusion coefficient(ADC) values were measured respectively in bilateral white matter of the frontal lobe, anterior cingulate gyrus, anterior cingulum, etc. At the same time, WMS values were detected respectively.

RESULTSRelative to controls, patients with OSAS had a lower FA in the white matter of right frontal lobe (0.444-/+0.025), splenium of corpus callosum (0.776-/+0.028 ), left anterior cingulate gyrus (0.154-/+0.021), right anterior cingulate gyrus (0.152-/+0.017), left anterior cingulum (0.372-/+0.022), right anterior cingulum (0.351-/+0.029), left centrum semiovale (0.501-/+0.029), peripheric white matter of left anterior angle (0.242-/+0.031), peripheric white matter of left posterior angle (0.338-/+0.029), peripheric white matter of right posterior angle (0.360-/+0.022 ), left parahippocampal gyrus (0.167-/+0.027), right parahippocampal gyrus (0.177-/+0.023). Besides, FA values of OSAS patients in the white matter of right frontal lobe and left centrum semiovale were strongly positively correlated with WMS values. While in comparison with that of healthy controls, ADC of OSAS patients was significantly higher in the white matter of right frontal lobe (8.589-/+0.264 x e(-10) mm(2)/s), trunk of corpus callosum (8.197-/+0.253 x e(-10) mm(2)/s), splenium of corpus callosum (8.218-/+0.194 x e(-10) mm(2)/s), left anterior cingulate gyrus (12.151-/+0.454 x e(-10) mm(2)/s), right anterior cingulate gyrus (12.113-/+0.524 x e(-10) mm(2)/s), right anterior cingulum (8.954-/+0.177 x e(-10) mm(2)/s),left centrum semiovale (7.333-/+0.220 x e(-10) mm(2)/s) and peripheric white matter of left anterior angle (9.186-/+0.465 x e(-10) mm(2)/s).

CONCLUSIONSThis study indicated that white matter and gray matter was both remarkably damaged in OSAS patients, which could contribute to memory impairment.

Adult ; Anisotropy ; Brain ; pathology ; Case-Control Studies ; Diffusion ; Humans ; Male ; Memory Disorders ; complications ; Middle Aged ; Sleep Apnea, Obstructive ; complications ; pathology

OBJECTIVETo elucidate the relation between cytochrome P4502D6 (CYP2D6) gene polymorphism and the susceptibility of heroin spongiform leucoencephalopathy (HSLE).

METHODSWith polymerase chain reaction-restriction fragment length polymorphism technique, the cytochrome P4502D6 gene polymorphisms were analyzed in HSLE cases and control subjects.

RESULTSThe frequencies of CYP2D6 (CYP2D6/C188, CYP2D6/L2938, CYP2D6/G4268) gene mutations were higher in HSLE patients than in the controls.

CONCLUSIONThe CYP2D6 gene mutation is associated with a high risk of HSLE.

Adult ; Canavan Disease ; chemically induced ; genetics ; Cytochrome P-450 CYP2D6 ; genetics ; Female ; Heroin ; adverse effects ; Heroin Dependence ; complications ; Humans ; Male ; Middle Aged ; Mutation ; Polymorphism, Restriction Fragment Length ; Young Adult

OBJECTIVETo summarize the clinical and radiographic characteristics of heroin spongiform leukoencephalopathy (HSLE).

METHODSA clinical analysis of 42 cases of HSLE was conducted.

RESULTSClinically, the patients with HSLE all had a positive history of inhalation of heated heroin vapor with acute or subacute onset in most cases, presenting initially cerebellar signs. Pyramidal tract lesion was frequently involved, but the sensory system usually remained normal. The consciousness disturbances may occur in the serious cases. Brain CT and magnetic resonance imaging (MRI) revealed extensive symmetric white matter lesions in the cerebrum and cerebellum, and in serious cases, the midbrain and pons could be damaged. Spongiform vacuoles degeneration of white matter characterized the predominant pathological changes.

CONCLUSIONSpongiform leukoencephalopathy should be considered in a patient who shows acute cerebellar signs and reports a history of inhaling heated heroin vapor, and a definite diagnosis of HSLE can be made in such a case upon the identification of typical CT or MRI findings.

Adult ; Brain ; pathology ; Female ; Heroin Dependence ; complications ; Humans ; Leukoencephalopathies ; chemically induced ; diagnosis ; pathology ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Tomography, X-Ray Computed ; Young Adult

Attention ; physiology ; Female ; Functional Laterality ; physiology ; Humans ; Middle Aged ; Neuropsychological Tests ; Prosopagnosia ; complications ; Space Perception ; physiology ; Stroke ; complications

Objective To study the relationships between hypertensive intracerebral hemorrhage (HICH) and family history of hypertensive disease, gender, age and disease course in Guangzhou. Methods The clinical profiles of 425 (269 male and 156 female) patients with HICH admitted to Nanfang Hospital, Guangzhou from 2000 to 2004 were collected. The relationships between disease incidences in different family histories of hypertensive disease, genders, ages, courses of disease and blood pressure were analyzed. Results In all 425 cases with HICH, the ratio of male to female of people with family history of hypertensive disease was significantly higher than that without in male.There were no obvious differences between with and without family history in female. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were higher in the male than in the female in young group. In middle-aged group and elder group, there were no significant differences in SBP and DBP between the male and the female. The distributions of SBP and DBP were all acute stage＞ subacute stage＞ convalescence stage. Conclusions Hypertensive disease should be supplied with different strategies of prevention and cure in accordance with different ages, genders and courses of disease, which can decrease the incidence of hypertensive intracerebral hemorrhage maximally.

OBJECTIVETo study the mechanisms of dystrophin gene deletion, the junction fragment with exons 45-54 deletion were cloned and sequenced.

METHODSA Duchenne muscular dystrophy (DMD) patient with exons 45-54 deletion has been substantiated by PCR amplification of the exons. Then we used a PCR-based genome-walking method for localizing the breakpoints in introns 44 and 54. At last, the deletion-junction fragment was directly amplified by PCR approach with forward and reverse primers annealing to a DNA sequence as close as possible to the breakpoints in introns 45 and 54. The sequencing result of the deletion-junction fragment was compared with the normal intronic sequences.

RESULTSA total of 2716 bp sequence containing the junction fragment was obtained. The 5' breakpoint was located in LINE/L1 element of intron 44 and close to a matrix attachment region (MAR). The 3' breakpoint was located in the minor potential MAR with topoisomerase II cleavage sites around. Beside the 3' breakpoint there was a 6 bp palindromic sequence. A 4 bp microhomologous sequence (AGAG) was in the joint of the deletion-junction fragment.

CONCLUSIONThe nonhomologous recombination caused by L1 repeated element, topoisomerase II cleavage sites, MARs and the nonhomologous end joining of microhomologous sequence may be the important factors in this huge gene fragment deletion.

Base Sequence ; Child ; Cloning, Molecular ; DNA Topoisomerases, Type II ; metabolism ; Dystrophin ; genetics ; Exons ; genetics ; Humans ; Introns ; genetics ; Male ; Muscular Dystrophy, Duchenne ; genetics ; Mutation ; Polymerase Chain Reaction ; Sequence Deletion