Background:Pineal cysts (PCs) are a benign lesion of the pineal gland that have been known to the medical community for a long time.With a prevalence rate of approximately 1% in the general population,PC is often a re...Background:Pineal cysts (PCs) are a benign lesion of the pineal gland that have been known to the medical community for a long time.With a prevalence rate of approximately 1% in the general population,PC is often a reason for medical counseling.The natural course of PC morphology has not been well described.In this study,we present a longitudinal magnetic resonance imaging (MRI) study of patients with PCs,with special focus on those who showed an increase or decrease in PC size.Methods:We enrolled all patients with a PC who were referred to our department between January 2000 and January 2018.Each patient underwent a clinical examination,and the patient's age,sex,and presenting signs and symptoms were noted.MRI was performed during periodic examinations,and a clinical and radiological course was reassessed.Results:In total,133 patients (99 women,34 men) were enrolled.The mean maximum diameter was 12.7 ± 5.2 mm (range 7-35 mm).PCs increased in size during the follow-up in seven patients (5.3%) and decreased in size in 10 (7.5%).The remaining cysts (n =116,87.2%) were stable over the follow-up period.Analyzing patients according to cyst size change,we found a significant difference in the mean age between the PC progression group and PC regression group (p =0.01).The mean size of the PCs at the time of diagnosis did not differ significantly between the two groups (p =0.81).We diagnosed two cases of pineal apoplexy.Conclusion:We found that PCs are a dynamic structure that may change in size during the patient's lifetime.Patients with an increase in PC size were significantly younger than patients with a decrease in size.Therefore,PC growth in the first,second,and third decennium is normal and does not justify medical intervention.Surgery is indicated in cases of hydrocephalus and Parinaud's syndrome or in atypical cysts when neoplasia is suspected.The size of a PC does not predict PC behavior in terms of a future increase or decrease in size.展开更多
Lesions of the rotator cuff(RC) are a common occurrence affecting millions of people across all parts of the globe. RC tears are also rampantly prevalent with an agedependent increase in numbers. Other associated fact...Lesions of the rotator cuff(RC) are a common occurrence affecting millions of people across all parts of the globe. RC tears are also rampantly prevalent with an agedependent increase in numbers. Other associated factors include a history of trauma, limb dominance, contralateral shoulder, smoking-status, hypercholesterolemia, posture and occupational dispositions. The challenge lies in early diagnosis since a high proportion of patients are asymptomatic. Pain and decreasing shoulder power and function should alert the heedful practitioner in recognizing promptly the onset or aggravation of existing RC tears. Partial-thickness tears(PTT) can be bursalsided or articular-sided tears. Over the course of time, PTT enlarge and propagate into full-thickness tears(FTT) and develop distinct chronic pathological changes due to muscle retraction, fatty infiltration and muscle atrophy. These lead to a reduction in tendon elasticity and viability. Eventually, the glenohumeral joint experiences a series of degenerative alterations- cuff tear arthropathy. To avert this, a vigilant clinician must utilize and corroborate clinical skill and radiological findings to identify tear progression. Modern radio-diagnostic means of ultrasonography and magnetic resonance imaging provide excellent visualization of structural details and are crucial in determining further course of action for these patients. Physical therapy along with activity modifications, antiinflammatory and analgesic medications form the pillars of nonoperative treatment. Elderly patients with minimal functional demands can be managed conservatively and reassessed at frequent intervals. Regular monitoring helps in isolating patients who require surgical interventions. Early surgery should be considered in younger, active and symptomatic, healthy patients. In addition to being costeffective, this helps in providing a functional shoulder witha stable cuff. An easily reproducible technique of maximal strength and sturdiness should by chosen among the armamentarium of the 展开更多
目的应用优化的基于体素的形态学研究方法(voxel based morphometry,VBM)比较家族性和散发性首发精神分裂症患者及其父母的脑结构差异。方法纳入家族性精神分裂症患者10例,其父母8例;散发性精神分裂症患者10例,其父母12例。同时纳入20...目的应用优化的基于体素的形态学研究方法(voxel based morphometry,VBM)比较家族性和散发性首发精神分裂症患者及其父母的脑结构差异。方法纳入家族性精神分裂症患者10例,其父母8例;散发性精神分裂症患者10例,其父母12例。同时纳入20例正常对照。采用优化的VBM方法处理高分辨T1加权图像,最后用两样本t检验分别比较两组患者及两组患者父母之间的脑灰质密度的差别。结果与散发性患者相比,家族性精神分裂症患者双侧丘脑的灰质密度均有降低。家族性分裂症患者父母的双侧丘脑、右侧海马旁回、左侧海马及左侧颞上回灰质密度较散发性患者父母降低。与正常对照相比,家族性及散发性精神分裂症患者双侧岛、右侧颞叶、右侧枕叶、左侧苍白球、右侧小脑及左侧额叶直回的灰质密度降低。两组患者的父母组中,只有家族性患者父母的一些脑区(包括右侧丘脑)的灰质密度较正常对照降低。结论家族性精神分裂症患者的双侧丘脑灰质密度较散发性患者显著降低,为以往研究中发现的家族性和散发性精神分裂症患者临床症状学的差异提供了脑结构的神经影像学证据。同时,家族性患者父母双侧丘脑的灰质密度较散发性患者父母也有明显降低,这一结果说明两组患者丘脑结构的差异与遗传有较大的关系。展开更多
目的分析精神分裂症（sehizophTenia，SZ）的脑表面积损伤情况及其与儿茶酚胺氧位甲基转移酶（catechnol-O-methyltransferase，COMT）基因的相关性，并探索家族性精神分裂症（familial patients with schizophrenia，FPS）和散发性精...目的分析精神分裂症（sehizophTenia，SZ）的脑表面积损伤情况及其与儿茶酚胺氧位甲基转移酶（catechnol-O-methyltransferase，COMT）基因的相关性，并探索家族性精神分裂症（familial patients with schizophrenia，FPS）和散发性精神分裂症（sporadic patients with schizophrenia，SPS）两亚型之间受损模式的差异。方法纳入98例首发及未治疗的SZ患者（58例SPS、40例FPS），78名正常对照。采用聚合酶链反应-限制性片段长度多态分析对受试者进行COMT基因分型。采集3．0T磁共振图像，应用Freesuffer软件分析sP和对照脑表面积的差异及其与COMT基因型的相关性。比较FPS、SPS和对照等3组的脑表面积。对多重比较结果进行Monte Carlo（P〈0．05）校正。结果SZ患者左前额叶和右枕叶脑区表面积减少，两组脑表面积与COMT基因型均无相关性。SPS患者左前额叶表面积低于FPS患者和对照；SPS患者右侧枕叶表面积低于对照。FPS与对照相比差异无统计学意义（P〉0．05）。结论SZ患者存在脑表面积损害，但与COMT基因型不相关。SPS患者受损大于FPS患者，提示两种SZ可能具有不同的发病机制。展开更多
文摘Background:Pineal cysts (PCs) are a benign lesion of the pineal gland that have been known to the medical community for a long time.With a prevalence rate of approximately 1% in the general population,PC is often a reason for medical counseling.The natural course of PC morphology has not been well described.In this study,we present a longitudinal magnetic resonance imaging (MRI) study of patients with PCs,with special focus on those who showed an increase or decrease in PC size.Methods:We enrolled all patients with a PC who were referred to our department between January 2000 and January 2018.Each patient underwent a clinical examination,and the patient's age,sex,and presenting signs and symptoms were noted.MRI was performed during periodic examinations,and a clinical and radiological course was reassessed.Results:In total,133 patients (99 women,34 men) were enrolled.The mean maximum diameter was 12.7 ± 5.2 mm (range 7-35 mm).PCs increased in size during the follow-up in seven patients (5.3%) and decreased in size in 10 (7.5%).The remaining cysts (n =116,87.2%) were stable over the follow-up period.Analyzing patients according to cyst size change,we found a significant difference in the mean age between the PC progression group and PC regression group (p =0.01).The mean size of the PCs at the time of diagnosis did not differ significantly between the two groups (p =0.81).We diagnosed two cases of pineal apoplexy.Conclusion:We found that PCs are a dynamic structure that may change in size during the patient's lifetime.Patients with an increase in PC size were significantly younger than patients with a decrease in size.Therefore,PC growth in the first,second,and third decennium is normal and does not justify medical intervention.Surgery is indicated in cases of hydrocephalus and Parinaud's syndrome or in atypical cysts when neoplasia is suspected.The size of a PC does not predict PC behavior in terms of a future increase or decrease in size.
文摘Lesions of the rotator cuff(RC) are a common occurrence affecting millions of people across all parts of the globe. RC tears are also rampantly prevalent with an agedependent increase in numbers. Other associated factors include a history of trauma, limb dominance, contralateral shoulder, smoking-status, hypercholesterolemia, posture and occupational dispositions. The challenge lies in early diagnosis since a high proportion of patients are asymptomatic. Pain and decreasing shoulder power and function should alert the heedful practitioner in recognizing promptly the onset or aggravation of existing RC tears. Partial-thickness tears(PTT) can be bursalsided or articular-sided tears. Over the course of time, PTT enlarge and propagate into full-thickness tears(FTT) and develop distinct chronic pathological changes due to muscle retraction, fatty infiltration and muscle atrophy. These lead to a reduction in tendon elasticity and viability. Eventually, the glenohumeral joint experiences a series of degenerative alterations- cuff tear arthropathy. To avert this, a vigilant clinician must utilize and corroborate clinical skill and radiological findings to identify tear progression. Modern radio-diagnostic means of ultrasonography and magnetic resonance imaging provide excellent visualization of structural details and are crucial in determining further course of action for these patients. Physical therapy along with activity modifications, antiinflammatory and analgesic medications form the pillars of nonoperative treatment. Elderly patients with minimal functional demands can be managed conservatively and reassessed at frequent intervals. Regular monitoring helps in isolating patients who require surgical interventions. Early surgery should be considered in younger, active and symptomatic, healthy patients. In addition to being costeffective, this helps in providing a functional shoulder witha stable cuff. An easily reproducible technique of maximal strength and sturdiness should by chosen among the armamentarium of the
文摘目的应用优化的基于体素的形态学研究方法(voxel based morphometry,VBM)比较家族性和散发性首发精神分裂症患者及其父母的脑结构差异。方法纳入家族性精神分裂症患者10例,其父母8例;散发性精神分裂症患者10例,其父母12例。同时纳入20例正常对照。采用优化的VBM方法处理高分辨T1加权图像,最后用两样本t检验分别比较两组患者及两组患者父母之间的脑灰质密度的差别。结果与散发性患者相比,家族性精神分裂症患者双侧丘脑的灰质密度均有降低。家族性分裂症患者父母的双侧丘脑、右侧海马旁回、左侧海马及左侧颞上回灰质密度较散发性患者父母降低。与正常对照相比,家族性及散发性精神分裂症患者双侧岛、右侧颞叶、右侧枕叶、左侧苍白球、右侧小脑及左侧额叶直回的灰质密度降低。两组患者的父母组中,只有家族性患者父母的一些脑区(包括右侧丘脑)的灰质密度较正常对照降低。结论家族性精神分裂症患者的双侧丘脑灰质密度较散发性患者显著降低,为以往研究中发现的家族性和散发性精神分裂症患者临床症状学的差异提供了脑结构的神经影像学证据。同时,家族性患者父母双侧丘脑的灰质密度较散发性患者父母也有明显降低,这一结果说明两组患者丘脑结构的差异与遗传有较大的关系。
文摘目的分析精神分裂症（sehizophTenia，SZ）的脑表面积损伤情况及其与儿茶酚胺氧位甲基转移酶（catechnol-O-methyltransferase，COMT）基因的相关性，并探索家族性精神分裂症（familial patients with schizophrenia，FPS）和散发性精神分裂症（sporadic patients with schizophrenia，SPS）两亚型之间受损模式的差异。方法纳入98例首发及未治疗的SZ患者（58例SPS、40例FPS），78名正常对照。采用聚合酶链反应-限制性片段长度多态分析对受试者进行COMT基因分型。采集3．0T磁共振图像，应用Freesuffer软件分析sP和对照脑表面积的差异及其与COMT基因型的相关性。比较FPS、SPS和对照等3组的脑表面积。对多重比较结果进行Monte Carlo（P〈0．05）校正。结果SZ患者左前额叶和右枕叶脑区表面积减少，两组脑表面积与COMT基因型均无相关性。SPS患者左前额叶表面积低于FPS患者和对照；SPS患者右侧枕叶表面积低于对照。FPS与对照相比差异无统计学意义（P〉0．05）。结论SZ患者存在脑表面积损害，但与COMT基因型不相关。SPS患者受损大于FPS患者，提示两种SZ可能具有不同的发病机制。
