Recently, many surgeons have been using intraoperative neurophysiological monitoring(IOM) in spinal surgery to reduce the incidence of postoperative neurological complications, including level of the spinal cord, caud...Recently, many surgeons have been using intraoperative neurophysiological monitoring(IOM) in spinal surgery to reduce the incidence of postoperative neurological complications, including level of the spinal cord, cauda equina and nerve root. Several established technologies are available and combined motor and somatosensory evoked potentials are considered mandatory for practical and successful IOM. Spinal cord evoked potentials are elicited compound potentials recorded over the spinal cord. Electrical stimulation is provoked on the dorsal spinal cord from an epidural electrode. Somatosensory evoked potentials assess the functional integrity of sensory pathways from the peripheral nerve through the dorsal column and to the sensory cortex. For identification of the physiological midline, the dorsal column mapping technique can be used. It is helpful for reducing the postoperative morbidity associated with dorsal column dysfunction when distortion of the normal spinal cord anatomy caused by an intramedullary cord lesion results in confusion in localizing the midline for the myelotomy. Motor evoked potentials(MEPs) consist of spinal, neurogenic and muscle MEPs. MEPs allow selective and specific assessment of the functional integrity of descending motor pathways, from the motor cortex to peripheral muscles. Spinal surgeons should understand the concept of the monitoring techniques and interpret monitoring records adequately to use IOM for the decision making during the surgery for safe surgery and a favorable surgical outcome.展开更多
Background: We present a compelling case fitting the phenomenon of cortical spreading depression detected by intraoperative neurophysiological monitoring (IONM) following an intraoperative seizure during a craniotomy ...Background: We present a compelling case fitting the phenomenon of cortical spreading depression detected by intraoperative neurophysiological monitoring (IONM) following an intraoperative seizure during a craniotomy for revascularization. Cortical spreading depression (CSD, also called cortical spreading depolarization) is a pathophysiological phenomenon whereby a wave of depolarization is thought to propagate across the cerebral cortex, creating a brief period of relative neuronal inactivity. The relationship between CSD and seizures is unclear, although some literature has made a correlation between seizures and a cortical environment conducive to CSD. Methods: Intraoperative somatosensory evoked potentials (SSEPs) and electroencephalography (EEG) were monitored continuously during the craniotomy procedure utilizing standard montages. Electrophysiological data from pre-ictal, ictal, and post-ictal periods were recorded. Results: During the procedure, intraoperative EEG captured a generalized seizure followed by a stepwise decrease in somatosensory evoked potential cortical amplitudes, compelling for the phenomenon of CSD. The subsequent partial recovery of neuronal function was also captured electrophysiologically. Discussion: While CSD is considered controversial in some aspects, intraoperative neurophysiological monitoring allowed for the unique analysis of a case demonstrating a CSD-like phenomenon. To our knowledge, this is the first published example of this phenomenon in which intraoperative neurophysiological monitoring captured a seizure, along with a stepwise subsequent reduction in SSEP cortical amplitudes not explained by other variables.展开更多
Anesthesiologists work to prevent or minimize secondary injury of the nervous system and improve the outcome of medical procedures.To this end,anesthesiologists must have a thorough understanding of pathophysiology an...Anesthesiologists work to prevent or minimize secondary injury of the nervous system and improve the outcome of medical procedures.To this end,anesthesiologists must have a thorough understanding of pathophysiology and optimize their skills and equipment to make an anesthesia plan.Anesthesiologists should conduct careful physical examinations of patients and consider neuroprotection at preoperative interviews,consider cervical spinal cord movement and compression during airway management,and suggest awake fiberoptic bronchoscope intubation for stable patients and direct laryngoscopy with manual in-line immobilization in emergency situations.During induction,anesthesiologists should avoid hypotension and depolarizing muscle relaxants.Mean artery pressure should be maintained within 85–90 mmHg（1 mmHg = 0.133 kPa; vasoactive drug selection and fluid management）.Normal arterial carbon dioxide pressure and normal blood glucose levels should be maintained.Intraoperative neurophysiological monitoring is a useful option.Anesthesiologists should be attentive to postoperative respiratory insufficiency（carefully considering postoperative extubation）,thrombus,and infection.In conclusion,anesthesiologists should carefully plan the treatment of patients with acute cervical spinal cord injuries to protect the nervous system and improve patient outcome.展开更多
Thoracic spinal stenosis (TSS) is a group of clinical syndromes caused by thoracic spinal cord compression, which always results in severe clinical complications. The incidence of TSS is relatively low compared with l...Thoracic spinal stenosis (TSS) is a group of clinical syndromes caused by thoracic spinal cord compression, which always results in severe clinical complications. The incidence of TSS is relatively low compared with lumbar spinal stenosis, while the incidence of spinal cord injury during thoracic decompression is relatively high. The reported incidence of neurological deficits after thoracic decompression reached 13.9%.Intraoperative neurophysiological monitoring (IONM) can timely provide information regarding the function status of the spinal cord, and help surgeons with appropriate performance during operation. This article illustrates the theoretical basis of applying IONM in thoracic decompression surgery, and elaborates on the relationship between signal changes in IONM and postoperative neurological function recovery of the spinal cord. It also introduces updated information in multimodality IONM, the factors influencing evoked potentials,and remedial measures to improve the prognosis.展开更多
Intramedullary tumors are a class of central nervous system tumors with an incidence of 2 to 4%.As they are located very deep and frequently cause postoperative neurological complications,surgical resection is difficu...Intramedullary tumors are a class of central nervous system tumors with an incidence of 2 to 4%.As they are located very deep and frequently cause postoperative neurological complications,surgical resection is difficult.In recent years,many surgeons have performed electrophysiological monitoring to effectively reduce the occurrence of post-operative neurological complications.Modern electrophysiological monitoring technology has advanced considerably,leading to the development of many monitoring methods,such as SSEPs,MEPs,DCM,and EMG,to monitor intramedullary tumors.However,electrophysiological monitoring in tumor resection is still being studied.In this article,we discussed the different monitoring methods and their role in monitoring intramedullary tumors by reviewing previous studies.Intratumorally tumors need to be monitored for a summary of the condition of the patient.Only by using various monitoring methods flexibly and through clear communication between surgeons and neurophysiological experts can good decisions be made during surgery and positive surgical results be achieved.展开更多
The aim of the present study is to contribute to the knowledge about the functioning of the neuronal circuits. We built a mathematical-computational model using graph theory for a complex neurophysiological circuit co...The aim of the present study is to contribute to the knowledge about the functioning of the neuronal circuits. We built a mathematical-computational model using graph theory for a complex neurophysiological circuit consisting </span><span style="font-family:Verdana;">of a reverberating neuronal circuit and a parallel neuronal circuit, which</span><span style="font-family:Verdana;"> could </span><span style="font-family:Verdana;">be coupled. Implementing our model in C++ and applying</span><span style="font-family:Verdana;"> neurophysiological values found in the literature, we studied the discharge pattern of the reverberant circuit and the parallel circuit separately for the same input signal pattern, examining the influence of the refractory period and the synaptic delay on the respective output signal patterns. Then, the same study was performed for the complete circuit, in which the two circuits were coupled, and the parallel circuit could then influence the functioning of the reverberant. The results showed that the refractory period played an important role in forming the pattern of the output spectrum of a reverberating circuit. The inhibitory action of the parallel circuit was able to regulate the reverberation frequency, suggesting that parallel circuits may be involved in the control of reverberation circuits related to motive activities underlying precision tasks and perhaps underlying neural work processes and immediate memories.展开更多
The main aim for discovery and development of the neurophysiological detector was detection of the production’ seats and criminal use of poisons in warfare. Phosphor-organic (PO) substances with acetylcholinesterase-...The main aim for discovery and development of the neurophysiological detector was detection of the production’ seats and criminal use of poisons in warfare. Phosphor-organic (PO) substances with acetylcholinesterase-blocking effects are prohibited in warfare by international law (Geneva Protocol. https://www.un.org/disarmament/wmd/bio/1925-geneva-protocol/). Monitoring PO analogs with acetylcholinesterase-blocking effects and their degradation products in water and soil can provide clues to unlawful production sites and the possible use of POs in warfare. Attempts to analyze POs by derivatization have had a low ability to detect them. A neurophysiological detector (NPD)-high-performance liquid chromatography (HPLC) system was developed for specific detection with high detection ability. The first official presentation of our NPD was at the 3<sup>rd</sup> International Symposium on Separation in BioSciences SBS 2003: A 100 Years of Chromatography, May 13-18, 2003, in Moscow, Russia. The NPD in connection to HPLC was developed 14 years before the presentation at the SBS in 2003. Initially, NPD combined with an HPLC system was developed for intelligence services and only for use in monitoring and espionage against the unlawful production of neuroparalytic agents, as explained in this article. NPD combined with an HPLC system was developed in Umeå, Sweden, in 1987-89;the protocol was further developed in Statens Plantevern Institutt, Ås, Norway, in 1990-92. NPD may have great utility during the current period of active warfare in Europe. The initial challenge was detecting unlawful production and use of PO compounds and their metabolites that can potentially block acetylcholinesterase. The sensor in NPD can detect and monitor substances such as tabun, soman, and modern PO poisons used in military applications. This article describes the history of the development of NPD and its aim as a sensitive sensor in detecting PO substances with acetylcholinesterase-blocking effects.展开更多
The restricted neurogenesis limits the brain ability to overcome neuronal cell death following ischemic lesion：Failure of the damaged brain to regenerate following cerebral ischemia results in functional deficits tho...The restricted neurogenesis limits the brain ability to overcome neuronal cell death following ischemic lesion：Failure of the damaged brain to regenerate following cerebral ischemia results in functional deficits those are most often irreversible and can further deteriorate,causing mortality and severe disability,progressive memory loss and cognitive impairments,known as dementia.展开更多
Neural stem cells(NSC)act as a versatile tool for neuronal cell replacement strategies to treat neurodegenerative disorders in which functional neurorestorative mechanisms are limited.While the beneficial effects of s...Neural stem cells(NSC)act as a versatile tool for neuronal cell replacement strategies to treat neurodegenerative disorders in which functional neurorestorative mechanisms are limited.While the beneficial effects of such cellbased therapy have already been documented in terms of neurodegeneration of various origins,a neurophysiological basis for improvement in the recovery of neurological function is still not completely understood.This overview briefly describes the cumulative evidence from electrophysiological studies of NSCderived neurons,aimed at establishing the maturation of differentiated neurons within a host microenvironment,and their integration into the host circuits,with a particular focus on the neurogenesis of NSC grafts within the post-ischemic milieu.Overwhelming evidence demonstrates that the host microenvironment largely regulates the lineage of NSC grafts.This regulatory role,as yet underestimated,raises possibilities for the favoured maturation of a subset of neural phenotypes in order to gain timely remodelling of the impaired brain tissue and amplify the therapeutic effects of NSC-based therapy for recovery of neurological function.展开更多
Objective: To observe advantages and disadvantages of the resection of intramedullary spinal cord tumor under awake anesthesia. Methods: Two patients with intramedullary spinal cord tumor underwent resection under awa...Objective: To observe advantages and disadvantages of the resection of intramedullary spinal cord tumor under awake anesthesia. Methods: Two patients with intramedullary spinal cord tumor underwent resection under awake anesthesia and followed up post-operatibely for any motor deficits. Results: Patients who underwent tumor resection under awake(AAA) anesthesia combined with intraoperative NPM had no motor deficits postoperatively. More accurate and nondelayed responses were observed in the awake cycle of anesthesia and helped guide surgery, thus avoiding injuries to the spinal cord. Conclusion: Intramedullary spinal cord tumors are not common, but only gross total resection(GTR) can provide complete remission of symptoms and progression-free survival. However, GTR sometimes results in motor function deficits postoperatively,particularly when the cervical cord is involved, and especially if surgery is done under general anesthesia with intraoperative neurophysiological monitoring(NPM) alone,because of delayed sensory evoked potential and motor evoked potential responses. We present two cases that underwent GTR of cervical intramedullary spinal cord tumors under an asleep-awake-asleep(AAA) cycle of anesthesia, combined with intraoperative NPM in which no post-operative motor deficits were observed on 6-months follow up.展开更多
Introduction: Despite recent advances in neuroimaging and microsurgical techniques, surgical resection of spinal cord tumours remains a challenge. However, the evolution with advances and refinement of neurophysiologi...Introduction: Despite recent advances in neuroimaging and microsurgical techniques, surgical resection of spinal cord tumours remains a challenge. However, the evolution with advances and refinement of neurophysiological equipment and methodologies, intra-operative neurophysiolo- gical monitoring (IONM) is now regarded as an essential adjunct to the surgical management of intramedullary spinal cord tumours. This study aims to report our preliminary experience with IONM and emphasise its effective role of achieving maximum tumour resection and minimising neurological injury. Methods: This is a retrospective study performed at our institution between July 2012 and August 2013. It included a cohort of 6 consecutive patients presented with intramedullary spinal cord tumours. Their mean age was 26 years (range, 4 months - 37 years), all were males, and the mean follow up was 11.6 months. Results: We combined the use of somatosensory evoked potentials (SSEPs) and motor evoked potentials (MEPs) in spinal cord surgery. SSEPs are monitored during the incision of the dorsal midline of the spinal cord and this was used in two of our patients and MEPs were used as an essential monitoring during the tumour resection. In addition, we used free-running electromyography (EMG) and muscle MEPs (mMEPs) during tumour resection. Four of our patients (two with ependymoma, one with ganglioglioma, and one with pilocytic astrocytoma) had complete tumour resection and two patients (pilocytic and diffuse astrocytoma) had IONM changes during surgery and had partial tumour resection. At 6-month follow up all our patients had made a good recovery with no new neurological sequelae. Conclusion: This small series and literature review is presented to add and improve the understanding of IONM in intramedullary spinal cord procedures and to reinforce the importance of IONM in optimising tumour resection and neurological outcome. Our series confirm that without D-wave monitoring, free-running EMG and MEP monitoring during tumour resection remain an展开更多
Purpose: To research the mechanism of neurophysiological treatment of amblyopia by observing the visual cortex activation under rotating grating stimulus with functional magnetic resonance imaging (MRI), and identify ...Purpose: To research the mechanism of neurophysiological treatment of amblyopia by observing the visual cortex activation under rotating grating stimulus with functional magnetic resonance imaging (MRI), and identify the components of the activation. Methods: Nine healthy volunteers were examined using gradient-recalled echo and echo-planar imaging (GRE-EPI) pulse sequence performed at the 1.5 Tesla MRI scanner. In the block designing, rotating grating, stationary grating and luminance were plotted as task states, stationary grating, luminance and darkness as control states, respectively. The tasks of stimuli included 6 steps. Imaging processing and statistical analysis were carried out off-line using statistical parametric mapping (SPM99) software in single-subject. Results: Some individual areas of visual cortex were activated by various stimuli information supplied by rotating grating. The strong activation in the middle of occipital lobe related to the stimuli of luminance, bilateral activation of Brodmann’s 19th area related to visual motion perception, and the mild activation in the middle of occipital lobe related to form perception. Conclusion: The plotting of control state is important in bock design. The effective visual information of rotating grating includes components of luminance, visual motion perception and form perception. Functional MRI has potential as a tool for studying the physiological mechanism of visual cortex.展开更多
A neurophysiological detector (NPD) is a hybridization of olfactory system neurons of the fish crucian carp, Carassius carassius L., with a computerized electronic device connected to a high-performance liquid chromat...A neurophysiological detector (NPD) is a hybridization of olfactory system neurons of the fish crucian carp, Carassius carassius L., with a computerized electronic device connected to a high-performance liquid chromatograph (HPLC). This system makes it possible to measure neurophysiological activities in the olfactory system of C. carassius L. after exposure of this fish to alarm pheromones. The construction of the system was presented for the first time at the 3rd International Symposium on Separation in Bio Sciences SBS 2003 in I. Brondz, et al., The Fish Olfactory System Used as an In-Line HPLC Neurophysiologic Detector NPD, 3rd Int. Symposium on Separation in Bio Sciences SBS 2003: A 100 Years of Chromatography, 13-18 May, Moscow, Russia, 2003, Abstract O- 27, p. 95. A complete paper was published in I. Brondz, et al., Neurophysiologic Detector (NPD)—A Selective and Sensitive Tool in High-Performance Liquid Chromatography, Chromatography B: Biomedical Sciences and Applications, Vol. 800, No. 1-2, 2004, pp. 41-47, and the hybridization of living cells with an electronic device has been discussed (I. Brondz, et al., International Scientific-Technical Conference Sensors Electronics and Microsystems Technology (SEMST-1), 1-5 June, (Odessa), Ukraine, 2004, Plenum Lecture, Abstract p. 17;I. Brondz, et al., The European Chemoreception Research Organization ECRO 2004 Congress, 12-15 September, (Dijon), France, 2004, Abstract P-3;and I. Brondz, et al., Biosensors as Electronic Compounds for Detector in the High-Performance Liquid Chromatography (HPLC), Electronic Components and Systems, Vol. 3, No. 103, 2006, pp. 25-27). In the present study, an HPLC equipped with an NPD was used to assess the influence of organophosphate (OP) pesticides on olfactory sensory nerves and the modification of nerve signals from the olfactory organ. The results show that exposure of the olfactory system to OP pesticides can lead to disruption of normal reflexes and to significant suppression of individual sexual activity and, as a result展开更多
The most prevalent among nervous system tumors significantly jeopardize patient health.For nerve integrity preservation after tumor removal,continuous intraoperative neurophysiological monitoring(CINM)is indispensable...The most prevalent among nervous system tumors significantly jeopardize patient health.For nerve integrity preservation after tumor removal,continuous intraoperative neurophysiological monitoring(CINM)is indispensable during microsurgery.The paper highlights the articles about the development of a system that employs soft and stretchable organic electronic materials for CINM.This innovative system harnesses soft and stretchable organic electronic materials and deploys conductive polymer electrodes with low impedance and modulus.These electrodes facilitate uninterrupted near-field action potential recording during surgery,resulting in enhanced signal-to-noise ratios and reduced invasiveness.Additionally,the system's multiplexing capabilities enable precise nerve localization,even in the absence of anatomical landmarks.展开更多
文摘Recently, many surgeons have been using intraoperative neurophysiological monitoring(IOM) in spinal surgery to reduce the incidence of postoperative neurological complications, including level of the spinal cord, cauda equina and nerve root. Several established technologies are available and combined motor and somatosensory evoked potentials are considered mandatory for practical and successful IOM. Spinal cord evoked potentials are elicited compound potentials recorded over the spinal cord. Electrical stimulation is provoked on the dorsal spinal cord from an epidural electrode. Somatosensory evoked potentials assess the functional integrity of sensory pathways from the peripheral nerve through the dorsal column and to the sensory cortex. For identification of the physiological midline, the dorsal column mapping technique can be used. It is helpful for reducing the postoperative morbidity associated with dorsal column dysfunction when distortion of the normal spinal cord anatomy caused by an intramedullary cord lesion results in confusion in localizing the midline for the myelotomy. Motor evoked potentials(MEPs) consist of spinal, neurogenic and muscle MEPs. MEPs allow selective and specific assessment of the functional integrity of descending motor pathways, from the motor cortex to peripheral muscles. Spinal surgeons should understand the concept of the monitoring techniques and interpret monitoring records adequately to use IOM for the decision making during the surgery for safe surgery and a favorable surgical outcome.
文摘Background: We present a compelling case fitting the phenomenon of cortical spreading depression detected by intraoperative neurophysiological monitoring (IONM) following an intraoperative seizure during a craniotomy for revascularization. Cortical spreading depression (CSD, also called cortical spreading depolarization) is a pathophysiological phenomenon whereby a wave of depolarization is thought to propagate across the cerebral cortex, creating a brief period of relative neuronal inactivity. The relationship between CSD and seizures is unclear, although some literature has made a correlation between seizures and a cortical environment conducive to CSD. Methods: Intraoperative somatosensory evoked potentials (SSEPs) and electroencephalography (EEG) were monitored continuously during the craniotomy procedure utilizing standard montages. Electrophysiological data from pre-ictal, ictal, and post-ictal periods were recorded. Results: During the procedure, intraoperative EEG captured a generalized seizure followed by a stepwise decrease in somatosensory evoked potential cortical amplitudes, compelling for the phenomenon of CSD. The subsequent partial recovery of neuronal function was also captured electrophysiologically. Discussion: While CSD is considered controversial in some aspects, intraoperative neurophysiological monitoring allowed for the unique analysis of a case demonstrating a CSD-like phenomenon. To our knowledge, this is the first published example of this phenomenon in which intraoperative neurophysiological monitoring captured a seizure, along with a stepwise subsequent reduction in SSEP cortical amplitudes not explained by other variables.
文摘Anesthesiologists work to prevent or minimize secondary injury of the nervous system and improve the outcome of medical procedures.To this end,anesthesiologists must have a thorough understanding of pathophysiology and optimize their skills and equipment to make an anesthesia plan.Anesthesiologists should conduct careful physical examinations of patients and consider neuroprotection at preoperative interviews,consider cervical spinal cord movement and compression during airway management,and suggest awake fiberoptic bronchoscope intubation for stable patients and direct laryngoscopy with manual in-line immobilization in emergency situations.During induction,anesthesiologists should avoid hypotension and depolarizing muscle relaxants.Mean artery pressure should be maintained within 85–90 mmHg（1 mmHg = 0.133 kPa; vasoactive drug selection and fluid management）.Normal arterial carbon dioxide pressure and normal blood glucose levels should be maintained.Intraoperative neurophysiological monitoring is a useful option.Anesthesiologists should be attentive to postoperative respiratory insufficiency（carefully considering postoperative extubation）,thrombus,and infection.In conclusion,anesthesiologists should carefully plan the treatment of patients with acute cervical spinal cord injuries to protect the nervous system and improve patient outcome.
文摘Thoracic spinal stenosis (TSS) is a group of clinical syndromes caused by thoracic spinal cord compression, which always results in severe clinical complications. The incidence of TSS is relatively low compared with lumbar spinal stenosis, while the incidence of spinal cord injury during thoracic decompression is relatively high. The reported incidence of neurological deficits after thoracic decompression reached 13.9%.Intraoperative neurophysiological monitoring (IONM) can timely provide information regarding the function status of the spinal cord, and help surgeons with appropriate performance during operation. This article illustrates the theoretical basis of applying IONM in thoracic decompression surgery, and elaborates on the relationship between signal changes in IONM and postoperative neurological function recovery of the spinal cord. It also introduces updated information in multimodality IONM, the factors influencing evoked potentials,and remedial measures to improve the prognosis.
文摘Intramedullary tumors are a class of central nervous system tumors with an incidence of 2 to 4%.As they are located very deep and frequently cause postoperative neurological complications,surgical resection is difficult.In recent years,many surgeons have performed electrophysiological monitoring to effectively reduce the occurrence of post-operative neurological complications.Modern electrophysiological monitoring technology has advanced considerably,leading to the development of many monitoring methods,such as SSEPs,MEPs,DCM,and EMG,to monitor intramedullary tumors.However,electrophysiological monitoring in tumor resection is still being studied.In this article,we discussed the different monitoring methods and their role in monitoring intramedullary tumors by reviewing previous studies.Intratumorally tumors need to be monitored for a summary of the condition of the patient.Only by using various monitoring methods flexibly and through clear communication between surgeons and neurophysiological experts can good decisions be made during surgery and positive surgical results be achieved.
文摘The aim of the present study is to contribute to the knowledge about the functioning of the neuronal circuits. We built a mathematical-computational model using graph theory for a complex neurophysiological circuit consisting </span><span style="font-family:Verdana;">of a reverberating neuronal circuit and a parallel neuronal circuit, which</span><span style="font-family:Verdana;"> could </span><span style="font-family:Verdana;">be coupled. Implementing our model in C++ and applying</span><span style="font-family:Verdana;"> neurophysiological values found in the literature, we studied the discharge pattern of the reverberant circuit and the parallel circuit separately for the same input signal pattern, examining the influence of the refractory period and the synaptic delay on the respective output signal patterns. Then, the same study was performed for the complete circuit, in which the two circuits were coupled, and the parallel circuit could then influence the functioning of the reverberant. The results showed that the refractory period played an important role in forming the pattern of the output spectrum of a reverberating circuit. The inhibitory action of the parallel circuit was able to regulate the reverberation frequency, suggesting that parallel circuits may be involved in the control of reverberation circuits related to motive activities underlying precision tasks and perhaps underlying neural work processes and immediate memories.
文摘The main aim for discovery and development of the neurophysiological detector was detection of the production’ seats and criminal use of poisons in warfare. Phosphor-organic (PO) substances with acetylcholinesterase-blocking effects are prohibited in warfare by international law (Geneva Protocol. https://www.un.org/disarmament/wmd/bio/1925-geneva-protocol/). Monitoring PO analogs with acetylcholinesterase-blocking effects and their degradation products in water and soil can provide clues to unlawful production sites and the possible use of POs in warfare. Attempts to analyze POs by derivatization have had a low ability to detect them. A neurophysiological detector (NPD)-high-performance liquid chromatography (HPLC) system was developed for specific detection with high detection ability. The first official presentation of our NPD was at the 3<sup>rd</sup> International Symposium on Separation in BioSciences SBS 2003: A 100 Years of Chromatography, May 13-18, 2003, in Moscow, Russia. The NPD in connection to HPLC was developed 14 years before the presentation at the SBS in 2003. Initially, NPD combined with an HPLC system was developed for intelligence services and only for use in monitoring and espionage against the unlawful production of neuroparalytic agents, as explained in this article. NPD combined with an HPLC system was developed in Umeå, Sweden, in 1987-89;the protocol was further developed in Statens Plantevern Institutt, Ås, Norway, in 1990-92. NPD may have great utility during the current period of active warfare in Europe. The initial challenge was detecting unlawful production and use of PO compounds and their metabolites that can potentially block acetylcholinesterase. The sensor in NPD can detect and monitor substances such as tabun, soman, and modern PO poisons used in military applications. This article describes the history of the development of NPD and its aim as a sensitive sensor in detecting PO substances with acetylcholinesterase-blocking effects.
文摘The restricted neurogenesis limits the brain ability to overcome neuronal cell death following ischemic lesion：Failure of the damaged brain to regenerate following cerebral ischemia results in functional deficits those are most often irreversible and can further deteriorate,causing mortality and severe disability,progressive memory loss and cognitive impairments,known as dementia.
文摘Neural stem cells(NSC)act as a versatile tool for neuronal cell replacement strategies to treat neurodegenerative disorders in which functional neurorestorative mechanisms are limited.While the beneficial effects of such cellbased therapy have already been documented in terms of neurodegeneration of various origins,a neurophysiological basis for improvement in the recovery of neurological function is still not completely understood.This overview briefly describes the cumulative evidence from electrophysiological studies of NSCderived neurons,aimed at establishing the maturation of differentiated neurons within a host microenvironment,and their integration into the host circuits,with a particular focus on the neurogenesis of NSC grafts within the post-ischemic milieu.Overwhelming evidence demonstrates that the host microenvironment largely regulates the lineage of NSC grafts.This regulatory role,as yet underestimated,raises possibilities for the favoured maturation of a subset of neural phenotypes in order to gain timely remodelling of the impaired brain tissue and amplify the therapeutic effects of NSC-based therapy for recovery of neurological function.
基金Supported by the Nanjing Science and Technology Project(No.20130345)Jiangsu Science and Technology Project–Clinical Medicine Special Grant(No.BL2014076)
文摘Objective: To observe advantages and disadvantages of the resection of intramedullary spinal cord tumor under awake anesthesia. Methods: Two patients with intramedullary spinal cord tumor underwent resection under awake anesthesia and followed up post-operatibely for any motor deficits. Results: Patients who underwent tumor resection under awake(AAA) anesthesia combined with intraoperative NPM had no motor deficits postoperatively. More accurate and nondelayed responses were observed in the awake cycle of anesthesia and helped guide surgery, thus avoiding injuries to the spinal cord. Conclusion: Intramedullary spinal cord tumors are not common, but only gross total resection(GTR) can provide complete remission of symptoms and progression-free survival. However, GTR sometimes results in motor function deficits postoperatively,particularly when the cervical cord is involved, and especially if surgery is done under general anesthesia with intraoperative neurophysiological monitoring(NPM) alone,because of delayed sensory evoked potential and motor evoked potential responses. We present two cases that underwent GTR of cervical intramedullary spinal cord tumors under an asleep-awake-asleep(AAA) cycle of anesthesia, combined with intraoperative NPM in which no post-operative motor deficits were observed on 6-months follow up.
文摘Introduction: Despite recent advances in neuroimaging and microsurgical techniques, surgical resection of spinal cord tumours remains a challenge. However, the evolution with advances and refinement of neurophysiological equipment and methodologies, intra-operative neurophysiolo- gical monitoring (IONM) is now regarded as an essential adjunct to the surgical management of intramedullary spinal cord tumours. This study aims to report our preliminary experience with IONM and emphasise its effective role of achieving maximum tumour resection and minimising neurological injury. Methods: This is a retrospective study performed at our institution between July 2012 and August 2013. It included a cohort of 6 consecutive patients presented with intramedullary spinal cord tumours. Their mean age was 26 years (range, 4 months - 37 years), all were males, and the mean follow up was 11.6 months. Results: We combined the use of somatosensory evoked potentials (SSEPs) and motor evoked potentials (MEPs) in spinal cord surgery. SSEPs are monitored during the incision of the dorsal midline of the spinal cord and this was used in two of our patients and MEPs were used as an essential monitoring during the tumour resection. In addition, we used free-running electromyography (EMG) and muscle MEPs (mMEPs) during tumour resection. Four of our patients (two with ependymoma, one with ganglioglioma, and one with pilocytic astrocytoma) had complete tumour resection and two patients (pilocytic and diffuse astrocytoma) had IONM changes during surgery and had partial tumour resection. At 6-month follow up all our patients had made a good recovery with no new neurological sequelae. Conclusion: This small series and literature review is presented to add and improve the understanding of IONM in intramedullary spinal cord procedures and to reinforce the importance of IONM in optimising tumour resection and neurological outcome. Our series confirm that without D-wave monitoring, free-running EMG and MEP monitoring during tumour resection remain an
基金supported by Nanjing Jinling Hospital ( 2004082) Basic application grant supported by The Department ofEducation of Jiangsu Province
文摘Purpose: To research the mechanism of neurophysiological treatment of amblyopia by observing the visual cortex activation under rotating grating stimulus with functional magnetic resonance imaging (MRI), and identify the components of the activation. Methods: Nine healthy volunteers were examined using gradient-recalled echo and echo-planar imaging (GRE-EPI) pulse sequence performed at the 1.5 Tesla MRI scanner. In the block designing, rotating grating, stationary grating and luminance were plotted as task states, stationary grating, luminance and darkness as control states, respectively. The tasks of stimuli included 6 steps. Imaging processing and statistical analysis were carried out off-line using statistical parametric mapping (SPM99) software in single-subject. Results: Some individual areas of visual cortex were activated by various stimuli information supplied by rotating grating. The strong activation in the middle of occipital lobe related to the stimuli of luminance, bilateral activation of Brodmann’s 19th area related to visual motion perception, and the mild activation in the middle of occipital lobe related to form perception. Conclusion: The plotting of control state is important in bock design. The effective visual information of rotating grating includes components of luminance, visual motion perception and form perception. Functional MRI has potential as a tool for studying the physiological mechanism of visual cortex.
文摘A neurophysiological detector (NPD) is a hybridization of olfactory system neurons of the fish crucian carp, Carassius carassius L., with a computerized electronic device connected to a high-performance liquid chromatograph (HPLC). This system makes it possible to measure neurophysiological activities in the olfactory system of C. carassius L. after exposure of this fish to alarm pheromones. The construction of the system was presented for the first time at the 3rd International Symposium on Separation in Bio Sciences SBS 2003 in I. Brondz, et al., The Fish Olfactory System Used as an In-Line HPLC Neurophysiologic Detector NPD, 3rd Int. Symposium on Separation in Bio Sciences SBS 2003: A 100 Years of Chromatography, 13-18 May, Moscow, Russia, 2003, Abstract O- 27, p. 95. A complete paper was published in I. Brondz, et al., Neurophysiologic Detector (NPD)—A Selective and Sensitive Tool in High-Performance Liquid Chromatography, Chromatography B: Biomedical Sciences and Applications, Vol. 800, No. 1-2, 2004, pp. 41-47, and the hybridization of living cells with an electronic device has been discussed (I. Brondz, et al., International Scientific-Technical Conference Sensors Electronics and Microsystems Technology (SEMST-1), 1-5 June, (Odessa), Ukraine, 2004, Plenum Lecture, Abstract p. 17;I. Brondz, et al., The European Chemoreception Research Organization ECRO 2004 Congress, 12-15 September, (Dijon), France, 2004, Abstract P-3;and I. Brondz, et al., Biosensors as Electronic Compounds for Detector in the High-Performance Liquid Chromatography (HPLC), Electronic Components and Systems, Vol. 3, No. 103, 2006, pp. 25-27). In the present study, an HPLC equipped with an NPD was used to assess the influence of organophosphate (OP) pesticides on olfactory sensory nerves and the modification of nerve signals from the olfactory organ. The results show that exposure of the olfactory system to OP pesticides can lead to disruption of normal reflexes and to significant suppression of individual sexual activity and, as a result
文摘The most prevalent among nervous system tumors significantly jeopardize patient health.For nerve integrity preservation after tumor removal,continuous intraoperative neurophysiological monitoring(CINM)is indispensable during microsurgery.The paper highlights the articles about the development of a system that employs soft and stretchable organic electronic materials for CINM.This innovative system harnesses soft and stretchable organic electronic materials and deploys conductive polymer electrodes with low impedance and modulus.These electrodes facilitate uninterrupted near-field action potential recording during surgery,resulting in enhanced signal-to-noise ratios and reduced invasiveness.Additionally,the system's multiplexing capabilities enable precise nerve localization,even in the absence of anatomical landmarks.
