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Clinical Significance of Left Atrial Anatomic Abnormalities Identified by Cardiac Computed Tomography

Advances in Computed Tomography 2015年第1期4卷 1-8页

作者： Ara V. Vehian Brian G. Choi Satinder S. Rekhi Heather A. Young Raman S. Dusaj Robert K. Zeman Department of Medicine George Washington University School of Medicine and Health Sciences Washington DC USA Department of Radiology George Washington University School of Medicine and Health Sciences Washington DC USA Department of Epidemiology and Biostatistics George Washington University School of Public Health and Health Services Washington DC USA division of Cardiovascular Medicine College of Medicine University of Florida Gainesville USA

Purpose: The clinical significance of newly identified left atrial anatomic abnormalities (LAAA)— accessory appendages, diverticula, septal pouches—by multidetector CT (MDCT) remains unclear. Similar anatomical outpouchings, i.e., the left atrial appendage, have been associated with cardioembolisms and arrhythmia. To test the hypothesis that LAAA are also associated with increased risk of these events, we performed a retrospective analysis to examine the association of LAAA in patients undergoing CT with embolic events and arrhythmia. Methods: 242 patients (mean age 56 SD 12 years, 41% female) were selected who had CT coronary angiography performed with 64-row MDCT between 2007 and 2012 if complete clinical history records were available. CT images were independently reviewed for the presence of LAAA. Association of cerebrovascular accident (CVA) or transient ischemic attack (TIA), atrial fibrillation, and palpitations to LAAA was calculated using odds ratios (OR) with 95% confidence interval (CI) and Fisher’s exact test. Results: After adjusting for age, sex, hypertension, dyslipidemia and diabetes via multiple logistic regression, patients with accessory appendages are more likely to have reported palpitations (OR: 1.80;CI: 1.03 - 3.16). Patients with diverticula and septal pouches are significantly older than those without these abnormalities (p = 0.01 and p = 0.02, respectively). Septal pouches are associated with diabetes (OR: 2.29;95%CI: 1.15 - 4.54). Conclusions: Accessory left atrial appendages are associated with palpitations. Patients with septal pouches and diverticula are significantly older than those patients without these anatomic abnormalities, suggesting age dependency of these findings. None of these anatomic abnormalities were associated with thromboembolic events after adjustment for potentially confounding comorbidities.

关键词： Left Atrium Anatomic Abnormalities Accessory Appendage Diverticula Septal Pouch

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脑血管病、冠心病和外周动脉病患者的口服抗血小板治疗

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美国医学会杂志（中文版） 2005年第5期24卷 286-293页

作者： Huyen Tran Sonia S. Anand 彭斌（译）李舜伟（校） Thromboembolism Unit Departmentof Medicine Faculty of Health Sciences McMaster University Hamilton Ontario. division of Cardiology Departmentof Medicine Faculty of Health Sciences McMaster University Hamilton Ontario. 不详

背景：动脉粥样硬化性血栓形成是一种可影响大脑、冠状动脉和外周动脉循环导致临床缺血事件的病理生理过程。单独或联合使用抗血小板制剂对预防血管病患者复发性血管事件有效。目的：对口服抗血小板治疗在脑血管病、冠心病（coronary ar... 详细信息

背景：动脉粥样硬化性血栓形成是一种可影响大脑、冠状动脉和外周动脉循环导致临床缺血事件的病理生理过程。单独或联合使用抗血小板制剂对预防血管病患者复发性血管事件有效。目的：对口服抗血小板治疗在脑血管病、冠心病（coronary artery disease，CAD）和外周动脉病患者的使用现状进行总结。证据获取：在MEDLINE数据库和Cochrane Groups试验登记站，使用急性冠脉综合征、动脉粥样硬化血栓形成、缺血性卒中、心肌梗死、外周动脉病、短暂脑缺血发作、不稳定心绞痛、阿斯匹林、噻氯匹啶、双嘧哒莫和氯吡格雷等关键词，检索1960年至2004年8月发表的研究。我们手工检索了杂志和文摘手册；查阅了有关试验和综述的参考文献；复习了汇总分析、学术声明和官方指南。证据综合：对于ST段升高心肌梗死患者，适宜的一线抗血小板药物为阿斯匹林；对于TIAs或卒中、慢性稳定型心绞痛或外周动脉疾病患者为阿斯匹林或氯吡格雷；对无ST段升高的急性冠脉综合征患者为阿斯匹林和氯吡格雷联合。对于首次出现TIA或卒中而临床没有明显CAD的患者，阿斯匹林与双嘧达莫合用是一种可能的选择。尽管已证明噻氯匹啶对许多血管病有益，但是其副作用限制了它的运用。结论：在不同的血管病患者亚组，阿斯匹林、噻氯匹啶、氯吡格雷、阿斯匹林与氯吡格雷联合使用以及阿斯匹林与双嘧达莫联合使用，在预防复发性血管事件方面是有效的。目前的临床试验证据支持将阿斯匹林或氯吡格雷作为绝大多数血管病患者的一线用药。评价联合应用抗血小板治疗的临床试验将指导今后的实际工作。

关键词：心肌梗死患者抗血小板治疗外周动脉病脑血管病冠心病口服 MEDLINE数据库动脉粥样硬化性急性冠脉综合征 Cochrane

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Decline in subarachnoid haemorrhage volumes associated with the first wave of the COVID- 19 pandemic

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Stroke & Vascular Neurology 2021年第4期6卷 542-552,I0026-I0032页

作者： Thanh N Nguyen Diogo C Haussen Muhammad M Qureshi Hiroshi Yamagami Toshiyuki Fujinaka Ossama Y Mansour Mohamad Abdalkader Michael Frankel Zhongming Qiu Allan Taylor Pedro Lylyk Omer F Eker Laura Mechtouff Michel Piotin Fabricio Oliveira Lima Francisco Mont'Alverne Wazim Izzath Nobuyuki Sakai Mahmoud Mohammaden Alhamza R Al-Bayati Leonardo Renieri Salvatore Mangiafico David Ozretic Vanessa Chalumeau Saima Ahmad Umair Rashid Syed Irteza Hussain Seby John Emma Griffin John Thornton Jose Antonio Fiorot Rodrigo Rivera Nadia Hammami Anna M Cervantes-Arslanian Hormuzdiyar H Dasenbrock Huynh Le Vu Viet Quy Nguyen Steven Hetts Romain Bourcier Romain Guile Melanie Walker Malveeka Sharma Don Frei Pascal Jabbour Nabeel Herial Fawaz Al-Mufti Atilla Ozcan Ozdemir Ozlem Aykac Dheeraj Gandhi Chandril Chugh Charles Matouk Pascale Lavoie Randall Edgell Andre Beer-Furlan Michael Chen Monika Killer-Oberpfalzer Vitor Mendes Pereira Patrick Nicholson Vikram Huded Nobuyuki Ohara Daisuke Watanabe Dong Hun Shin Pedro SC Magalhaes Raghid Kikano Santiago Ortega-Gutierrez Mudassir Farooqui Amal Abou-Hamden Tatsuo Amano Ryoo Yamamoto Adrienne Weeks Elena A Cora Rotem Sivan-Hoffmann Roberto Crosa Markus Möhlenbruch Simon Nagel Hosam Al-Jehani Sunil A Sheth Victor S Lopez Rivera James E Siegler Achmad Fidaus Sani Ajit S Puri Anna Luisa Kuhn Gianmarco Bernava Paolo Machi Daniel G Abud Octavio M Pontes-Neto Ajay K Wakhloo Barbara Voetsch Eytan Raz Shadi Yaghi Brijesh P Mehta Naoto Kimura Mamoru Murakami Jin Soo Lee Ji Man Hong Robert Fahed Gregory Walker Eiji Hagashi Steve M Cordina Hong Gee Roh Ken Wong Juan F Arenillas Mario Martinez-Galdamez Jordi Blasco Alejandro Rodriguez Vasquez Luisa Fonseca M Luis Silva Teddy Y Wu Simon John Alex Brehm Marios Psychogios William J Mack Matthew Tenser Tatemi Todaka Miki Fujimura Roberta Novakovic Jun Deguchi Yuri Sugiura Hiroshi Tokimura Rakesh Khatri Michael Kelly Lissa Peeling Yuichi Murayama Hugh Stephen Winters Johnny Wong Mohamed Teleb Jeremy Payne Hiroki Fukuda Kosuke Miyake Junsuke Shimbo Yusuke Sug Neurology RadiologyBoston Medical CenterBostonMassachusettsUSA Neurology Marcus Stroke&Neuroscience CenterGrady Memorial HospitalEmory University School of MedicineAtlantaGAUSA Radiology Radiation OncologyBoston University School of MedicineBostonMassachusettsUSA Neurology National Hospital Organization Osaka National HospitalOsakaJapan Neurosurgery National Hospital Organization Osaka National HospitalOsakaJapan Neurology Alexandria UniversityAlexandriaEgypt Radiology Boston Medical CenterBostonMassachusettsUSA Department of Neurology Xinqiao HospitalChongqingChina Neurosurgery University of Cape TownRondeboschWestern CapeSouth Africa Neurosurgery Interventional NeuroradiologyClinica La Sagrada FamiliaBuenos AiresArgentina Neuroradiologie Neurologie VasculaireHospices Civils de LyonLyonAuvergne-Rhône AlpesFrance Neurologie Vasculaire Hospices Civils de LyonLyonAuvergne-Rhône AlpesFrance Interventional Neuroradiology Fondation Ophtalmologique Adolphe de RothschildParisÎle-de FranceFrance Neurology Hospital Geral de FortalezaFortalezaBrazil Interventional Neuroradiology Hospital Geral de FortalezaFortalezaBrazil Neuroradiology Nottingham University Hospitals NHS TrustNottinghamUK Department of Neurosurgery Kobe City Medical Center General HospitalKobeHyogoJapan Interventional Neurovascular Unit University Hospital CareggiFirenzeToscanaItaly Neuroradiology University Hospital Centre ZagrebZagrebCroatia Interventional Neuroradiology Hopital BicetreLe Kremlin-BicetreFrance Stroke and Interventional Neuroradiology Lahore General HospitalLahorePakistan Neurological Institute Cleveland Clinic Abu DhabiAbu DhabiUAE Department of Radiology Beaumont HospitalDublinIreland Neurology Stroke UnitHospital-Estadual CentralVitoriaBrazil Neuroradiology Instituto de Neurocirugia Dr AsengoSantiagoChile Interventional Neuroradiology Institut National de NeurologieTunisTunisia Neurology Boston Medical CenterBostonMassachusettsUSA Neurosurgery Boston Medical Center

Background During the COVID-19 pandemic,decreased volumes of stroke admissions and mechanical thrombectomy were *** study’s objective was to examine whether subarachnoid haemorrhage(SAH)hospitalisations and ruptured aneurysm coiling interventions demonstrated similar *** We conducted a cross-sectional,retrospective,observational study across 6 continents,37 countries and 140 comprehensive stroke *** with the diagnosis of SAH,aneurysmal SAH,ruptured aneurysm coiling interventions and COVID-19 were identified by prospective aneurysm databases or by International Classification of Diseases,10th Revision,*** 3-month cumulative volume,monthly volumes for SAH hospitalisations and ruptured aneurysm coiling procedures were compared for the period before(1 year and immediately before)and during the pandemic,defined as 1 March-31 May *** prior 1-year control period(1 March-31 May 2019)was obtained to account for seasonal *** There was a significant decline in SAH hospitalisations,with 2044 admissions in the 3 months immediately before and 1585 admissions during the pandemic,representing a relative decline of 22.5%(95%CI−24.3%to−20.7%,p<0.0001).Embolisation of ruptured aneurysms declined with 1170-1035 procedures,respectively,representing an 11.5%(95%CI−13.5%to−9.8%,p=0.002)relative *** analysis was noted for aneurysmal SAH hospitalisation decline from 834 to 626 hospitalisations,a 24.9%relative decline(95%CI−28.0%to−22.1%,p<0.0001).A relative increase in ruptured aneurysm coiling was noted in low coiling volume hospitals of 41.1%(95%CI 32.3%to 50.6%,p=0.008)despite a decrease in SAH admissions in this *** There was a relative decrease in the volume of SAH hospitalisations,aneurysmal SAH hospitalisations and ruptured aneurysm embolisations during the COVID-19 *** findings in SAH are consistent with a decrease in other emergencies,such as stroke and myocardial infarction.

关键词： diagnosis representing subarachnoid

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Using MR Techniques to Detect Neuroprotection of Pinocembrin on TBI in Rats

Using MR Techniques to Detect Neuroprotection of Pinocembrin...

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第二届国际抑郁共病暨第十二届中国中西医结合基础理论学术研讨会

作者：王文竹 Heng Fan Hong Zhang Jinyuan Zhou Xi Huang Jian Wang Department of Anesthesiology and Critical Care Medicine Johns Hopkins UniversitySchool of Medicine Department of Integrated Chinese and West Medicine Union HospitalTongji Medical CollegeHuazhong University of Science and Technology division of MR Research Department of RadiologyJohns Hopkins University School of Medicine Institute of TCM-Related Comorbid Depression Nanjing University of Chinese Medicine

Objective:Traumatic brain injury(TBI) results in primary injury and secondary injury cascades,such as ischemia,progressive neurodegeneration,persistent inflammation,glial hypertrophy and proliferation,and cerebrovascular ***,no drug is effective for treatment of *** pinocembrin was shown to be neuroprotective after cerebral ischemia in ***,its potential protection in TBI has not been *** this study,we subjected rats to a controlled cortical impact(CCI)-TBI model and used molecular magnetic resonance imaging(MRI) techniques to examine whether pinocembrin can provide ***:Thirty-one adult male SD rats were randomly divided into four groups:sham group(n=5);vehicle-treated TBI group(n=6),TBI group treated with 5 mg/kg pinocembrin(n=10),and TBI group treated with 10 mg/kg pinocembrin(n=10).Rats from the vehicle and pinocembrin groups were subjected to craniotomy plus CCI surgery(3-mm impact tip,velocity of 5 m/sec,deformation depth of 5 mm,and impact duration of 65 msec) under isoflurane *** from the sham group received scalp incision,but the skull was kept *** was injected through the tail vein at 30 min and 1,2,and 3 days after *** data were acquired on a 4.7 T animal imager,using T2 w,T2*w,T2,isotropic diffusion image apparent diffusion coefficient(ADC),CBF,and amide proton transfer(APT)-weighted(APTw;RF saturation power/time 1.3μT/4 sec) *** imaging is a novel molecular MRI method that can noninvasively detect endogenous mobile protein and tissue pH *** images were quantified by using the magnetization transfer-ratio asymmetry at 3.5 ppm from *** was performed at 1 h and 1,3,7,14,and 28 days after *** volume was measured by T2 w MRI at various time *** was used to detect microglia/macrophage and astrocyte *** walking,rotarod test,and modified neurological severity score(mNSS)were used to assess the recovery of sens

关键词： Pinocembrin Traumatic brain injury APTw ADC Neurolucida

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动脉粥样硬化血栓形成门诊患者1年内心血管事件的发生率

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美国医学会杂志（中文版） 2007年第4期26卷 195-203页

作者： Gabriel Steg Deepak L. Bhatt Peter W. F. Wilson Ralph D＇ Agostino E. Magnus Ohman Joachim Roether Chiau-Suong Liau Alan T. Hirsch Jean-Louis Mas Yasuo Ikeda Michael J. Pencina Shinya Goto 徐成斌（译）李呈亿（校） Departement de Cardiologie Hopital Bichat-Claude Bernard Paris France Department of Cardiovascular Medicine Cleveland Clinic Cleveland Ohio Cardiology division Emory University School of Medicine Atlanta Ga Statistics and Consulting Unit Department of Mathematics and Statistics Boston University Boston Mass division of Cardiology Duke University Durham NC Department of Neurology Klinikum Minden Minden Germany Department of internal Medicine National Taiwan University Hospital and School of Medicine Taipei Taiwan Minneapolis Heart Institute Foundation and division of Epidemiology and Community Health University of Minnesota School of Public Health Minneapolis Service de Neurologie Centre Raymond Garcin Hopital Sainte-Anne Paris France Department of Internal Medicine Keio University School of Medicine Tokyo Japan Department of Medicine Tokai University School of Medicine Kanagawa Japan 不详

背景：目前，有关社区中动脉粥样硬化血栓形成稳定患者心血管（cardiovascular，CV）事件发生率的资料比较少，既往也无国际性队列研究对冠状动脉病（coronary artery disease，CAD）、脑血管病（cerebrovascular disease，CVD）、外周... 详细信息

背景：目前，有关社区中动脉粥样硬化血栓形成稳定患者心血管（cardiovascular，CV）事件发生率的资料比较少，既往也无国际性队列研究对冠状动脉病（coronary artery disease，CAD）、脑血管病（cerebrovascular disease，CVD）、外周动脉病（peripheral arterial disease，PAD）确诊患者以及此类疾病高危患者不同事件的发生率进行评估。目的：在患有动脉疾病的门诊患者或存在多个动脉粥样硬化血栓形成危险因素的门诊患者中确定当今世界1年内CV事件的发生率。设计、地点及参试者：“减少动脉粥样硬化血栓形成维系健康（Reduction of Artherotllrombosis for Continued Health，REACH）”注册研究是一项国际前瞻性队列研究。研究人员于2003—2004年从44个国家、5587名医生入选68236例已确诊的动脉粥样硬化性血管病患者（CAD、PAD、CVD；n=55814）以及至少存在3个动脉粥样硬化血栓形成危险因素的患者（n=12422）。主要观测指标：CV死亡、心肌梗死（myocardial infarction，MI）及卒中的发生率。结果：截至2006年7月，共有95．22％的患者（n=64977）提供了1年内的结局。心血管死亡、MI及卒中的总体发生率为4．24％；动脉粥样硬化性血管病患者为4．69％，仅存在多个危险因素的患者为2．15％。CAD、CVD及PAD患者CV死亡、MI及卒中的总体发生率分别为4．52％、6．47％和5．35％。CAD、CVD及PAD患者发生终点事件（即CV死亡、MI、卒中）以及因动脉粥样硬化血栓形成事件入院的几率分别为15．20％、14．53％和21．14％。上述事件发生率随症状性动脉疾病病变部位数量的增加而增加，仅存在危险因素的患者为5．31％，有1处症状性动脉疾病的患者为12．58％，有2处症状性动脉疾病的患者为21．14％，有3处症状性动脉疾病的患者为26．27％（趋势P〈0．001）。结论：在这项当代大型国际研究中，患有动脉粥样硬化性血管病的门诊患者以及有动脉粥样硬化血栓形成危险的门诊患者CV事件的年发生率相对较高。存在多部位病变者CV事件的1年发生率升高。

关键词：动脉粥样硬化血栓形成心血管事件年发生率门诊患者动脉粥样硬化性血管病前瞻性队列研究 arterial 动脉疾病

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临床人群脑血管储备的CO2血氧依赖水平MR绘图:安全性、耐受性和技术可行性

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国际医学放射学杂志 2013年第2期 175-176页

作者： V. R. Spano D.M. Mandell J. Poublanc K. Sam A. Battisti-Charbonney O. Pucci 郭凌飞 The Joint Department of Medical Imaging Division of Neuroradiology Toronto Western Hospital University Health Network University of Toronto 399 Bathurst St 3MC-431 Toronto ON Canada M5T 2S8

目的评估使用精确的前瞻性靶向CO2激励和血氧水平依赖MR成像对临床人群脑血管反应性(CVR)绘图的安全性、耐受性、技术可行性。材料与方法机构伦理委员会批准了三级医院在2006年1月1日—2010年12月1日对所有CVR的研究进行病历审查,均获... 详细信息

目的评估使用精确的前瞻性靶向CO2激励和血氧水平依赖MR成像对临床人群脑血管反应性(CVR)绘图的安全性、耐受性、技术可行性。材料与方法机构伦理委员会批准了三级医院在2006年1月1日—2010年12月1日对所有CVR的研究进行病历审查,均获得病人的知情同意。检索不利事件的发生和失败的检查。2名观察者采用双盲法对CVR图的诊断质量进行评估,分为好、可诊断但质量差、无法诊断。结果作为原始数据并进行描述性统计(均值±标准差)。使用同类相关系数来测定观察者内部的变异度。结果对294例病人(女性占51.8%)的432次连贯的CVR检查进行研究。病人年龄范围9～88岁[平均(45.9±20.6)岁]。有48次检查(11.1%)在高碳酸血症阶段出现气促、头痛、头晕等短暂症状,均未出现神经病学中的脑缺血事件、心肌梗死和其他主要并发症。CVR影像生成的成功率为83.9%(364/434次)。另外70次检查失败(16.1%),其中有25次感到不适(35.7%),8次(11.4%)出现头部移动,2次(2.9%)为不能合作,10次(10.0%)为设备出现技术性障碍,28次为情况不明或未说明状态。在364次成功的检查中,质量好的CVR图为340次(93.4%),可诊断但质量差的有12次(3.3%),无法诊断的有12次(3.3%)。结论在临床病人的研究中,使用精确的前瞻性靶向CO2激励和血氧水平依赖MR成像所产生的CVR图是安全的、可耐受的,并且技术上也是可行的。

关键词： CVR 耐受性 CO2 二氧化碳 MR 血氧

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Pseudoexfoliation syndrome and cardiovascular diseases

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World Journal of Cardiology 2014年第8期6卷 847-854页

作者： Georgios K Andrikopoulos Dimitrios K Alexopoulos Sotirios P Gartaganis Department of Ophthalmology University of Patras Medical School26504 PatrasGreece Department of Internal Medicine Division of CardiologyUniversity of Patras Medical School26504 PatrasGreece

Pseudoexfoliation(PEX) syndrome is a well-recognized late-onset disease caused by a generalized fibrillopathy. It is linked to a broad spectrum of ocular complications including glaucoma and perioperative problems during cataract surgery. Apart from the long-known intraocular manifestations, PEX deposits have been found in a variety of extraocular locations and they appear to represent a systemic process associated with increased cardiovascular and cerebrovascular morbidity. However, as published results are inconsistent, the clinical significance of the extraocular PEX deposits remains controversial. Identification of PEX deposits in the heart and the vessel wall, epidemiologic studies, as well as, similarities in pathogenetic mechanisms have led to the hypothesis of a possible relation between fibrillar material and cardiovascular disease. Recent studies suggest that PEX syndrome is frequently linked to impaired heart and blood vessels function. Systemic and ocular blood flow changes, altered parasympathetic vascular control and baroreflex sensitivity, increased vascular resistance and decreased blood flow velocity, arterial endothelial dysfunction, high levels of plasma homocysteine and arterial hypertension have all been demonstrated in PEX subjects. Common features in the pathogenesis of both atherosclerosis and PEX, like oxidative stress and inflammation and a possible higher frequency of abdominal aorta aneurysm in PEX patients, could imply that these grey-white deposits and cardiovascular disorders are related or reflect different manifestations of the same process.

关键词： Pseudoexfoliation Cardiovascular disease cerebrovascular disease Coronary artery disease Homocysteine

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Vascular depression for radiology: A review of the construct,methodology,and diagnosis

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World Journal of Radiology 2020年第5期12卷 48-67页

作者： Sara N Rushia Al Amira Safa Shehab Jeffrey N Motter Dakota A Egglefield Sophie Schiff Joel R Sneed Ernst Garcon Department of Psychology The Graduate CenterCity University of New YorkNew YorkNY 10016United States Department of Psychology Queens CollegeCity University of New YorkQueensNY 11367United States division of Geriatric Psychiatry New York State Psychiatric InstituteNew YorkNY 10032United States Department of Psychiatry Columbia University Medical CenterNew YorkNY 10032United States Department of Radiology Columbia University Medical CenterNew YorkNY 10032United States

Vascular depression(VD)as defined by magnetic resonance imaging(MRI)has been proposed as a unique subtype of late-life *** VD hypothesis posits that cerebrovascular disease,as characterized by the presence of MRIdefined white matter hyperintensities,contributes to and increases the risk for depression in older *** is also accompanied by cognitive impairment and poor antidepressant treatment *** VD diagnosis relies on MRI findings and yet this clinical entity is largely unfamiliar to neuroradiologists and is rarely,if ever,discussed in radiology *** primary purpose of this review is to introduce the MRI-defined VD construct to the neuroradiology *** reports are highlighted in order to illustrate the profile of VD in terms of radiological,clinical,and neuropsychological findings.A secondary purpose is to elucidate and elaborate on the measurement of cerebrovascular disease through visual rating scales and semi-and fully-automated volumetric *** methods are crucial for determining whether lesion burden or lesion severity is the dominant pathological contributor to ***,these rating methods have implications for the growing field of computer assisted *** VD has been found to have a profile that is distinct from other types of late-life depression,neuroradiologists,in conjunction with psychiatrists and psychologists,should consider VD in diagnosis and treatment planning.

关键词： Vascular depression Depression Magnetic resonance imaging cerebrovascular disorders White matter hyperintensities Neuroradiology Case reports

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Head Position of Patients with Right Hemisphere Damage during a Visual Search Task in a Large Field

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World Journal of Neuroscience 2018年第2期8卷 190-202页

作者： Ken Nakatani Shusuke Takahashi Daisuke Kimura Masako Notoya Nobuyuki Sunahara Takashi Fujita Minoru Toyama Shinya Fukunaga Naoe Mori Kiyoe Sakai Shinya Fuwa Department of Rehabilitation Sciences Kansai University of Welfare Sciences Osaka Japan Department of Living and Welfare Faculty of Home Economics Kyoto Women’s University Kyoto Japan Department of Speech and Hearing Sciences and Disorders Kyoto Gakuen University Kyoto Japan School of Health Sciences College of Medical Pharmaceutical and Health Sciences Kanazawa University Kanazawa Japan division of Occupational Therapy Faculty of Care and Rehabilitation Seijoh University Tōkai Japan Department of Sensory Science Faculty of Health Science and Technology Kawasaki University of Medical Welfare Kurashiki Japan

Spatial neglect syndrome with cerebral lesions is characterized by the ina-bility to orient, report, or respond to relevant visual stimuli contralateral to the lesions. In this study, we investigated the pattern of horizontal visual search in a large space;this search was performed by patients with right hemisphere damage caused by cerebrovascular disease. The neck rotation angle and search time in each increment were continuously recorded during the task, and quantitative data of the measurements were collected. Head position during the visual search task in a large space (%) was then calculated. We set angular bands in increments of 5 degrees from the midline on the left and right sides, and calculated the total search time in each angular band. In patients with unilateral spatial neglect (USN), the search time in the angular band of 5 - 9 on the right side was significantly longer (with USN 16.7%, without USN 4.5%, t = 2.52, df = 16, p < 0.05). Furthermore, in patients with neglect in the leftmost end area in a large space, the search time was significantly shorter in the angular band of 1 - 4 degrees to the left (with neglect 13.1%, without neglect 23.7%, t = 2.13, df = 16, p < 0.05), and tended to be long in the angular band of 5 - 9 to the right. The neck rotation angle and pattern during the search task in a large field deviated slightly to the right, and the search time slightly to the left was short. We believe that these results support the rightward deviation of the search pattern and frame of USN patients.

关键词： Head Position Neck Rotation Angle Unilateral Spatial Neglect Visual Exploration

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降压治疗与脑卒中二级预防:脑卒中后降压治疗研究

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中华高血压杂志 2010年第4期18卷 329-334页

作者：王增武刘力生龚兰生张宇清 Lutgarde Thijs Jan A.Staessen 王继光中国医学科学院北京协和医学院阜外心血管病医院北京100037 上海交通大学医学院上海瑞金医院高血压研究所上海200025 the Studies Coordinating Centre Division of Hypertension and Cardiovascular RehabilitationDepartment of Cardiovascular DiseasesUniversity of Leuven

目的评价对于中国患者脑血管病后降压治疗是否可以预防脑卒中再发。方法采取双盲、安慰剂对照的试验方法,将患者随机分入对照组(n=2825)和干预组(吲达帕胺2.5 mg/d,n=2840)。一级终点事件为致死或非致死性再发脑卒中,二级终点事件为主... 详细信息

目的评价对于中国患者脑血管病后降压治疗是否可以预防脑卒中再发。方法采取双盲、安慰剂对照的试验方法,将患者随机分入对照组(n=2825)和干预组(吲达帕胺2.5 mg/d,n=2840)。一级终点事件为致死或非致死性再发脑卒中,二级终点事件为主要的致死或非致死心血管病事件。结果平均收缩压和舒张压分别为153.8和92.8 mm Hg。在随访中期(第2年),干预组收缩压/舒张压较对照组平均下降了6.8/3.3 mm Hg。干预组总共有159例再发脑卒中,对照组为219例(干预组HR=0.70;95%CI0.57～0.86;P<0.01)。干预组有199例发生心血管病事件,对照组为258例(HR=0.74;95%CI0.62～0.89;P=0.002)。结论吲达帕胺降压治疗可以降低中国人脑血管病患者再发脑卒中和心血管病事件。

关键词：降压治疗血压脑卒中二级预防

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