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Current opinion in neurology and neurosurgery最新文献

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Disorders of the spinal cord and cauda equina. 脊髓和马尾的疾病。
Current opinion in neurology and neurosurgery Pub Date : 1993-08-01
T N Byrne
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引用次数: 0
Prospects for prevention of neural tube defects by vitamin supplementation. 补充维生素预防神经管缺损的前景。
Current opinion in neurology and neurosurgery Pub Date : 1993-08-01
J L Mills, J L Simpson
{"title":"Prospects for prevention of neural tube defects by vitamin supplementation.","authors":"J L Mills,&nbsp;J L Simpson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Recent studies have resolved the debate over the role of vitamins in preventing neural tube defects. The British Medical Research Council trial demonstrated that 4 mg of folate daily, but not other vitamins, prevented 72% of recurrences. The Hungarian trial prevented neural tube defects in women who had not previously had affected children by giving multivitamins containing 0.8 mg of folate. The US Public Health Service currently recommends that women at risk for becoming pregnant take 0.4 mg of folate daily. Unfortunately, most pregnancies are unplanned, and women not planning to become pregnant may not follow this recommendation. Therefore, the US Food and Drug Administration is exploring methods of food fortification. Because large doses of folate have been reported to ameliorate B12 deficiency anemia while allowing neurologic damage to progress, and to cause electroencephalogram abnormalities in epileptics, it is important to plan fortification carefully and to monitor both toxicity and benefits.</p>","PeriodicalId":77089,"journal":{"name":"Current opinion in neurology and neurosurgery","volume":"6 4","pages":"554-8"},"PeriodicalIF":0.0,"publicationDate":"1993-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19384886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Disorders of the spinal cord and cauda equina. 脊髓和马尾的疾病。
Current opinion in neurology and neurosurgery Pub Date : 1993-08-01
{"title":"Disorders of the spinal cord and cauda equina.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77089,"journal":{"name":"Current opinion in neurology and neurosurgery","volume":"6 4","pages":"621-31"},"PeriodicalIF":0.0,"publicationDate":"1993-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19384895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Chemical mediators of autonomic nervous system activity. 自主神经系统活动的化学介质。
Current opinion in neurology and neurosurgery Pub Date : 1993-08-01
D S Goldstein
{"title":"Chemical mediators of autonomic nervous system activity.","authors":"D S Goldstein","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Several modifications have improved the sensitivity and specificity of neurochemical tests to diagnose and distinguish multiple system atrophy and pure autonomic failure. These include [3H]-norepinephrine infusion to estimate plasma norepinephrine clearance; neuroendocrine stimulation tests; and simultaneous measurements of levels of levodopa, catecholamines, and catecholamine metabolites. New clinical imaging approaches have the potential to visualize alterations in neurotransmitter function in the brain and periphery. Patients with multiple system atrophy have decreased striatal radioactivity after injection of positron-emitting ligands at dopamine receptors or uptake sites, and patients with diffuse sympathetic denervation have decreased myocardial radioactivity after injection of radioactive sympathoneural imaging agents.</p>","PeriodicalId":77089,"journal":{"name":"Current opinion in neurology and neurosurgery","volume":"6 4","pages":"524-6"},"PeriodicalIF":0.0,"publicationDate":"1993-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19097715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Experimental aspects of spinal cord regeneration. 脊髓再生的实验方面。
Current opinion in neurology and neurosurgery Pub Date : 1993-08-01
M E Schwab
{"title":"Experimental aspects of spinal cord regeneration.","authors":"M E Schwab","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Sprouting, elongation, and functional reconnection are the necessary steps for successful regeneration of lesioned axons. Induction of growth-specific proteins in adult cells and of lesioned fibers sprouting can occur spontaneously in central nervous system neurons and may be enhanced by specific neurotrophic factors. The extremely limited elongation commonly observed in the adult central nervous system depends crucially on the presence of neurite growth-inhibitory molecules, such as those associated with central nervous system myelin or several candidate molecules expressed in glial scars. Optic nerve axons guided into their targets by peripheral nerve bridges were able to restore functional synapses in adult rats, showing that the relevant recognition mechanisms are present. Important steps in the cellular and molecular understanding of these basic processes of lesioned axon regeneration are being taken at present and significant progress can be expected in the near future.</p>","PeriodicalId":77089,"journal":{"name":"Current opinion in neurology and neurosurgery","volume":"6 4","pages":"549-53"},"PeriodicalIF":0.0,"publicationDate":"1993-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19384885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Investigation and treatment of autonomic circulatory failure. 自主循环衰竭的调查与治疗。
Current opinion in neurology and neurosurgery Pub Date : 1993-08-01
W Wieling, J J van Lieshout
{"title":"Investigation and treatment of autonomic circulatory failure.","authors":"W Wieling,&nbsp;J J van Lieshout","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Investigation and treatment of patients suffering from autonomic circulatory failure should be based on the application of knowledge of basic physiology to the problem of a particular patient. For an overall evaluation of cardiovascular autonomic dysfunction, an analysis of the heart rate and blood pressure responses to standing usually is sufficient. Instruction in physical maneuvers such as squatting and leg crossing should be part of the treatment programs to reduce disabilities from orthostatic hypotension in patients with circulatory autonomic failure.</p>","PeriodicalId":77089,"journal":{"name":"Current opinion in neurology and neurosurgery","volume":"6 4","pages":"537-43"},"PeriodicalIF":0.0,"publicationDate":"1993-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19384883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Spinal imaging. 脊髓成像。
Current opinion in neurology and neurosurgery Pub Date : 1993-08-01
W Coughlin, G Sze
{"title":"Spinal imaging.","authors":"W Coughlin,&nbsp;G Sze","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The application of magnetic resonance imaging has changed the evaluation of most disorders of the spinal axis. Contrast agents improve lesion conspicuousness and new sequences decrease both imaging time and artifacts. Myelography, computed tomography, and angiography continue to have well-defined, albeit limited, roles in spinal imaging.</p>","PeriodicalId":77089,"journal":{"name":"Current opinion in neurology and neurosurgery","volume":"6 4","pages":"571-5"},"PeriodicalIF":0.0,"publicationDate":"1993-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19384889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Molecular mechanisms of trauma-induced neuronal degeneration. 创伤性神经元变性的分子机制。
Current opinion in neurology and neurosurgery Pub Date : 1993-08-01
S A Lipton
{"title":"Molecular mechanisms of trauma-induced neuronal degeneration.","authors":"S A Lipton","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Recent studies suggest that various neuron-specific responses, including activation of glutamate receptors, muscarinic receptors, and oxidative stress, contribute to the events leading to brain and spinal cord neuronal degeneration after trauma. These specific mechanisms and possible future treatments are highlighted in this review.</p>","PeriodicalId":77089,"journal":{"name":"Current opinion in neurology and neurosurgery","volume":"6 4","pages":"588-96"},"PeriodicalIF":0.0,"publicationDate":"1993-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19384892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Dopamine receptor pharmacology. 多巴胺受体药理学。
Current opinion in neurology and neurosurgery Pub Date : 1993-08-01
P Seeman, H H Van Tol
{"title":"Dopamine receptor pharmacology.","authors":"P Seeman,&nbsp;H H Van Tol","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Although antipsychotic drugs originally helped to discover dopamine receptors, the five dopamine receptors presently identified and cloned are facilitating the search for and discovery of more selective antipsychotic and antiparkinson drugs. The D1-like dopamine receptors, D1 and D5, are sensitive to the same drugs as the D1 receptor in native tissues, but D5 is about 10 times more sensitive to dopamine than D1. The D2-like receptors, D2, D3, and D4, have approximately similar sensitivities to dopamine, but bromocriptine and raclopride are both about two orders of magnitude weaker at D4, whereas clozapine is one order more potent at D4, as compared with D2 and D3. The human dopamine D4 receptor has many variants. The sensitivities to clozapine of human variants D4.2, D4.4, and D4.7 are approximately similar, with dissociation constants between 5 and 24 nM, matching the spinal fluid concentration of clozapine under therapeutic conditions. Thus antipsychotic action may be effected through blockade of either dopamine D2 or D4 receptors.</p>","PeriodicalId":77089,"journal":{"name":"Current opinion in neurology and neurosurgery","volume":"6 4","pages":"602-8"},"PeriodicalIF":0.0,"publicationDate":"1993-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19097718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Reflex sympathetic dystrophy. 反射性交感神经营养不良。
Current opinion in neurology and neurosurgery Pub Date : 1993-08-01
R J Schwartzman
{"title":"Reflex sympathetic dystrophy.","authors":"R J Schwartzman","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Reflex sympathetic dystrophy is a progressive illness most often initiated by trauma to a nerve, plexus, or soft tissue. Its five components are pain, edema, autonomic dysfunction, movement disorder, and trophic changes. The illness evolves in stages that progress insidiously over time. The length of time a patient remains in a specific stage is unknown. In any stage of reflex sympathetic dystrophy, the symptom complex may be dissociated. Reflex sympathetic dystrophy occurs in one part of the body that seems to sensitize a patient so that a succeeding injury may initiate the process in the newly traumatized area. The length of time this sensitization lasts is unknown. Pain is the most disabling and the most difficult aspect of the illness to treat. At least in early stages the pain is sympathetically maintained, but with time becomes sympathetically independent. The alpha 1 adrenoreceptor appears to be the peripheral link that, when activated, sensitizes directly or indirectly C-nociceptor fibers. Dynamic mechanoallodynia is mediated by A beta low threshold mechanoreceptors, whereas static primary mechanical hyperalgesia may be mediated by sensitized C-nociceptors. A peripheral afferent C-nociceptor input appears to be necessary to alter the dorsal horn central processing mechanisms to allow for the expression of dynamic mechanoallodynia. This nociceptive barrage could be driven by the sympathetic efferent outflow or could be sympathetically independent. The response of immediate early response genes may change the neuropeptide concentration of the dorsal horn. Central sensitization mediated by excitatory amino acids, neuropeptides, and the N-methyl-D-aspartate receptor may be responsible for the severe pain seen in the later stages of the illness.</p>","PeriodicalId":77089,"journal":{"name":"Current opinion in neurology and neurosurgery","volume":"6 4","pages":"531-6"},"PeriodicalIF":0.0,"publicationDate":"1993-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19384985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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