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A case of the 'perfect storm' of myelin oligodendrocyte glycoprotein (MOG) antibody-mediated myelitis, human herpesvirus 6 (HHV-6) reactivation, and COVID-19 infection was reported in 2021. This article reports a case of a similarly observed clinical triad, but with a different conclusion and explanation supported by laboratory test results and evidence from our literature review.
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Herpesvirus 6, Human , Myelitis , Optic Neuritis , Humans , Herpesvirus 6, Human/genetics , Autoantibodies , Myelin-Oligodendrocyte GlycoproteinABSTRACT
BACKGROUND: Poly-D, L-lactic acid (PDLLA) is increasingly used as a commercial dermal filler due to its lasting cosmetic properties. Consequently, PDLLA-related vascular complications are increasingly recognized and described. Herein, we describe the first known occurrence of multifocal strokes from the use of PDLLA as a cosmetic dermal filler, and discuss the mechanisms facilitating PDLLA's entry into the intracranial arterial system. CASE PRESENTATION: A middle-aged female presented with acute vision loss of both eyes immediately after dermal injections of PDLLA to her nasolabial folds and infraorbital regions. There were no additional neurological deficits. Dilated fundal examination revealed retinal edema bilaterally, with deposition of filler material in the retinal arteries. Magnetic resonance imaging of her brain and orbits demonstrated multifocal strokes (left caudate head, right medial frontal lobe) and ischemia of the left optic nerve. The temporal proximity of the dermal injections to her symptoms, guided by fundal examination and neuroimaging findings, allowed us to attribute her strokes and ischemic optic neuropathy to PDLLA's entry into, and embolism within, the intracranial arterial system. She was treated with hyperbaric oxygen therapy and experience improvement to her right eye's vision, although poor vision persisted in her left eye. CONCLUSION: While PDLLA is generally considered safe, its increasing use as a cosmetic filler renders it crucial for physicians to be cognizant of its vascular complications, especially when early recognition and treatment are essential in mitigating their devastating ramifications.
Subject(s)
Cosmetic Techniques , Dermal Fillers , Stroke , Humans , Middle Aged , Female , Dermal Fillers/adverse effects , Cosmetic Techniques/adverse effects , Injections , Vision Disorders , Eye , Stroke/diagnostic imaging , Stroke/etiology , Stroke/therapyABSTRACT
Liquid chromatography-tandem mass spectrometry (LC-MS/MS) technology has the characteristics of high specificity and high throughput, making it rapidly applied and developed in the field of clinical testing. Its application in the monitoring of therapeutic drugs can effectively improve the quantitative accuracy and sensitivity, and formulate a personalized and optimal dosing plan for patients. However, this technology still faces some challenges, and automation, quality control, and quantitative traceability will be the future development direction.
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Meteorological conditions play a key role in the occurrence and evolution of atmospheric complex pollution. Considering the different pollution formation mechanisms of PM2.5 and O3, statistical calculation and in-depth learning methods were used to construct the PM2.5 and O3 meteorological condition indexes based on long-term pollution meteorological observation data. A research method was developed to study the meteorological characteristics and impact contribution of atmospheric complex pollution by using the meteorological condition index, and quantitative analysis of the distribution and variation of pollution excluding the influence of regional meteorological differences was also conducted. The results showed that in the summer of 2021, the pollution meteorological conditions in the key regions in central and eastern China were generally worse in the north and better in the south(index:"2+26" cities>the border area of Jiangsu, Anhui, Shandong, and Henan>the Yangtze River Delta) and the worst in June and the best in July. The "double high" pollution began to appear when the PM2.5 meteorological condition index>30 and O3 meteorological condition index>100; meanwhile, the unfavorable meteorological conditions for O3 also promoted the increase in PM2.5 concentration, resulting in the frequency of "double high" increases with the increase in O3 meteorological condition index. Compared with that during the same period last year, ρ(PM2.5) of each region decreased by 3.9 µg·m-3, 3.3 µg·m-3, and 1.4 µg·m-3 due to the contribution of the improvement in the pollution meteorological conditions, which is nearly 58.5% on average of the total decrease in PM2.5 concentration. However, the change in O3 pollution meteorological conditions was better in the north and worse in the south, and the overall deterioration in the Yangtze River Delta Region led to approximately 2.8 µg·m-3 growth for the O3 concentration. The PM2.5 and O3 concentrations after excluding the impact of meteorological differences showed different distribution characteristics from the air quality monitoring, in which the high concentrations of PM2.5 were distributed along the Bohai Sea, the inter-provincial border, and the south of the region, whereas the high concentrations of O3 were concentrated along the Taihang Mountains, around Mount Tai, and in parts of the Yangtze River Delta. The daily concentration variations in a single city during a specific pollution control period could be used as a basis for evaluating the effectiveness of local supervision and control, which will provide a reference for the dynamic supervision and daily scheduling of local control management.
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In this paper, research was conducted on Deep Learning Wavefront Sensing (DLWS) neural networks using simulated atmospheric turbulence datasets, and a novel DLWS was proposed based on attention mechanisms and Convolutional Neural Networks (CNNs). The study encompassed both indoor experiments and kilometer-range laser transmission experiments employing DLWS. In terms of indoor experiments, data were collected and training was performed on the platform built by us. Subsequent comparative experiments with the Shack-Hartmann Wavefront Sensing (SHWS) method revealed that our DLWS model achieved accuracy on par with SHWS. For the kilometer-scale experiments, we directly applied the DLWS model obtained from the indoor platform, eliminating the need for new data collection or additional training. The DLWS predicts the wavefront from the beacon light PSF in real time and then uses it for aberration correction of the emitted laser. The results demonstrate a substantial improvement in the average peak intensity of the light spot at the target position after closed-loop correction, with a remarkable increase of 5.35 times compared to the open-loop configuration.
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BACKGROUND: Lumbosacral radiculoplexus neuropathy, also known as amyotrophy, is an uncommon monophasic disorder characterized by inflammation of the lumbosacral nerve roots and plexuses. Lumbosacral radiculoplexus neuropathy is usually associated with diabetes mellitus, is typically painful at presentation, and often associated with long-term residual neurologic deficits. We report a case of painless, nondiabetic lumbosacral radiculoplexus neuropathy in a young Chinese woman, who made a full recovery after treatment with intravenous immunoglobulin, adding an atypical case to the scarce literature on lumbosacral radiculoplexus neuropathy. CASE PRESENTATION: A 35-year-old Chinese woman presented to our emergency department with 1-week history of painless left lower limb weakness and numbness. Examination revealed weakness confined to the left lower limb but spanning various nerves and myotomes, with abnormal sensation. Clinical localization to the lumbosacral plexus was supported by neurodiagnostic tests, and magnetic resonance imaging of the lumbosacral plexus showed that the nerve roots were also involved. After treatment with intravenous immunoglobulin for nondiabetic lumbosacral radiculoplexus neuropathy, the patient had a full recovery. CONCLUSION: Our patient's case highlights that lumbosacral radiculoplexus neuropathy, an already rare disorder, can occur in the absence of diabetes mellitus and pain, making it even harder to recognize. A systematic and meticulous clinical approach, supported by intelligent selection of adjunctive tests, is required for localization and diagnosis. With an accurate diagnosis, our case also demonstrates that appropriate and prompt treatment can lead to complete recovery, despite previous reports suggesting a high prevalence of long-term residual deficits after lumbosacral radiculoplexus neuropathy.
Subject(s)
Diabetic Neuropathies , Radiculopathy , Female , Humans , Adult , Diabetic Neuropathies/complications , Diabetic Neuropathies/diagnosis , Diabetic Neuropathies/drug therapy , Immunoglobulins, Intravenous/therapeutic use , Radiculopathy/diagnosis , Radiculopathy/drug therapy , Lumbosacral Plexus/pathology , PainABSTRACT
Background and aim: In China, acupuncture and moxibustion have been used effectively to treat various diseases for thousands of years. However, the evidence for a difference in the efficacies of moxibustion and acupuncture in cerebral infarction treatment is scarce. We aimed to compare the effects of acupuncture and moxibustion treatment on the Nogo/NgR signaling pathway in rats with cerebral ischemia/reperfusion (I/R) injury. Experimental procedure: Eighty male SD rats were randomly divided into five groups, based on treatment received: sham surgery (sham group), middle cerebral artery occlusion (MCAO, MCAO group), MCAO and NEP(1-40) inhibitor injection (MCAO + block group), MCAO and moxibustion (MCAO + moxi group), and MCAO and minimal acupuncture (MCAO + MA group). Neurological status was evaluated before treatment, and cerebral infarction volume (IV) and neurological function; Nogo-A, NgR, p75NTR, and LINGO-1 expressions; and NgR and LINGO-1 co-expression were assessed after treatment. Results and conclusion: After treatment, barring Nogo-A mRNA and protein expression in the MCAO + block group, the Longa score and IV significantly decreased; Nogo-A, NgR, p75NTR, and LINGO-1 mRNA and protein expressions as well as NgR and LINGO-1 co-expression significantly decreased in cerebral tissues; whereas the BWT score increased (P < 0.01) in the MCAO + moxi group, compared with the MCAO group. Except for NgR and LINGO-1 protein expressions, there were no significant differences in the abovementioned parameters between rats that underwent acupuncture and moxibustion. Acupuncture and moxibustion have similar effects on Nogo/NgR signaling pathway inhibition after cerebral infarction.
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OBJECTIVE: To observe the effect of electroacupunctureï¼EAï¼ on the expression of cytosolic phospholipase A2 ï¼cPLA2ï¼ and apoptosis of nerve cells in rats with spinal cord injury ï¼SCIï¼, so as to explore its mechanisms underlying improvement of SCI. METHODS: Seventy-two female SD rats were randomly divided into model, EA, antagonist and EA+antagonist groups, with 18 rats in each group and other 18 rats were used as the sham operation ï¼shamï¼ group. The SCI model was established by referring to modified Allen's method with a weight impactor. The hindlimb motor function was assessed by using Basso-Beattie-Bresnahan ï¼BBBï¼ score. Rats of the EA group were subjected to EA stimulation at "Dazhui"ï¼GV14ï¼, "Yaoyangguan"ï¼GV3ï¼, bilateral "Ciliao"ï¼BL32ï¼ and "Zusanli"ï¼ST36ï¼ for 20 min, once a day for 14 days. Rats of the antagonist group received intravenous injection followed by intraperitoneal injection of arachidonyl trifluoromethyl ketone ï¼AACOCF3, antagonist of cPLA2ï¼, once every other day. Rats of the EA+antagonist group received EA treatment combined with antagonist injection. After the treatment, the rats were sacrificed and the spinal cord tissue was collected for detecting the protein expression of cPLA2, p-cPLA2, Bcl-2, Bax and Caspase-3 by Western blot, and the mRNA expression of cPLA2, Bcl-2, Bax and Caspase-3 using qRT-PCR. The morphological changes of the spinal cord were detected by Nissl staining. RESULTS: In comparison with the sham group, the BBB score, expression of Bcl-2 protein and mRNA were significantly down-regulated ï¼P<0.01ï¼, whereas the expression levels of Bax, Caspase-3 and p-cPLA2 proteins and mRNAs were considerably up-regulated in the model group ï¼P<0.01ï¼. Compared with the model group, the BBB score, expression levels of Bcl-2 protein and mRNA were significantly up-regulated ï¼P<0.01, P<0.05ï¼, while the expression levels of Bax, Caspase-3 and p-cPLA2 proteins in the EA, antagonist and EA+antagonist groups, Bax and cPLA2 mRNAs in both antagonist and EA+antagonist groups, and Caspase-3 mRNA in the EA+antagonist group were obviously down-regulated ï¼P<0.01, P<0.05ï¼. The effect of EA+antagonist was significantly superior to EA in increasing BBB score and in lowering expression of Bax and cPLA2 mRNAs ï¼P<0.01, P<0.05ï¼. Nissl staining showed reduced number of nerve cells and Nissl bodies, and striped dark blue cells in the model group, which was milder in the EA and antagonist groups, particularly in the EA+antagonist group. CONCLUSION: EA may improve the limb motor function of SCI rats, which may be related to its functions in down-regulating the expression of p-cPLA2, Bax and Caspase-3 and up-regulating Bcl-2 to reduce the apoptosis of nerve cells in the regional spinal cord.
Subject(s)
Electroacupuncture , Spinal Cord Injuries , Animals , Female , Rats , Apoptosis/genetics , bcl-2-Associated X Protein , Caspase 3/genetics , Lower Extremity , Neurons , Rats, Sprague-Dawley , Spinal Cord Injuries/genetics , Spinal Cord Injuries/therapy , Phospholipases A2, Cytosolic/metabolismABSTRACT
AIMS: To describe the clinical features and outcomes of anti-NMDA receptor encephalitis (ANMDARE) in Southeast Asian (SEA) patients. METHOD: SEA patients diagnosed and treated for ANMDARE at Singapore General Hospital between January 2010 and June 2020 were included in this observational study, in which their clinical features and outcomes were retrospectively analysed. RESULTS: We studied 20 patients: 11 Chinese, 3 Tagalogs, 2 Malays, 2 Indians, 1 Eurasian and 1 Javanese. Their median age was 28 years. 15 were females, amongst whom teratomas were demonstrated in 13 (12 ovarian, 1 mediastinal). Delirium and seizures were the two commonest events leading to their presentation at our facility. 1 male had biliary neuroendocrine tumour. Comparison between genders revealed a strong male predilection for early seizures and insomnia; females were four times likelier than males to develop movement disorders or have underlying neoplasms. Patients with dysautonomia required longer ICU stay beyond 14 days, but their outcomes at 1 year did not differ. When reviewed at 1 year, none had clinical relapses, and outcomes were favourable (mRS 0-2) in nearly two-thirds. CONCLUSIONS: SEA patients with ANMDARE frequently present with delirium and seizures. Underlying neoplasms are very common in females. Differences in clinical characteristics may exist between the two genders. Recognition of these can facilitate diagnosis, and permit earlier initiation of appropriate treatment strategies, and thus improve outcomes of SEA patients.
Subject(s)
Anti-N-Methyl-D-Aspartate Receptor Encephalitis , Delirium , Humans , Male , Female , Adult , Anti-N-Methyl-D-Aspartate Receptor Encephalitis/diagnosis , Anti-N-Methyl-D-Aspartate Receptor Encephalitis/epidemiology , Anti-N-Methyl-D-Aspartate Receptor Encephalitis/therapy , Longitudinal Studies , Retrospective Studies , Neoplasm Recurrence, Local , Seizures/epidemiology , Seizures/etiology , Asia, Southeastern/epidemiologyABSTRACT
AIM: This study aims to describe the clinical characteristics of patients with isolated oculomotor nerve palsy from COVID-19 infection, and provide guidance on their treatment and management. METHODS: We performed a systematic review and retrospective analysis on the clinical features and outcomes of patients with isolated oculomotor nerve palsy from COVID-19 reported in literature over the past three years. RESULTS: We analyzed a total of 11 cases; 9 identified in literature from January 2020 to September 2022, together with our two patients. Their median age was 46 years (range 2-65), and three were children. More than half (6/11, 55 %) were without medical history. Oculomotor nerve palsies tended to occur early (longest interval of 16 days), but they can also occur concurrently (2/11, 18 %) or before the appearance of COVID-19 symptoms (1/11, 9 %). COVID-19 symptoms tended to be mild (8/11, 73 %). Oculomotor nerve palsies, however, displayed neither a clear gender predilection, nor consistent clinical features in terms of the severity of extraocular weakness and the involvement of pupillary light responses. Nearly two-thirds (7/11, 64 %) received no pharmacological treatment. Regardless, recovery was complete in nearly all (9/10, 90 %), with most occurring within a month (8/9, 89 %) CONCLUSION: Isolated oculomotor nerve palsies are early but uncommon complications of COVID-19. They affect patients with mild infections, and can be the first symptom. Prognosis is excellent, with recovery being often complete and early. Early discharge and outpatient clinical review, with or without short courses of oral steroids, are reasonable treatment measures.
Subject(s)
COVID-19 , Oculomotor Nerve Diseases , Child , Humans , Child, Preschool , Adolescent , Young Adult , Adult , Middle Aged , Aged , Retrospective Studies , COVID-19/complications , Oculomotor Nerve Diseases/etiology , Oculomotor Nerve Diseases/complications , Prognosis , Oculomotor NerveABSTRACT
Objective:To evaluate laparoscopic choledocholithotomy in patients with cholecystolithiasis and normal sized common bile duct(CBD) with choledocholithiasis.Methods:The clinical data of 393 patients with cholecystolithiasis and choledocholithiasis treated by LC combined with LCBDE at the Department of General Surgery of Hefei Second People's Hospital from Mar 2014 to Jul 2021 were retrospectively analyzed.Results:There were 280 CBD calculi cases in which CBD diameter >8 mm which was included into CBD dilated group, and 113 cases of CBD calculi with normal diameter (5 mm≤CBD diameter ≤8 mm). There was no difference in operative time and postoperative complications in the small diameter group. During the follow-up period, 1 case in the dilated group experienced biliary tract stenosis and treated by stenting. There was no statistical significance in biliary tract stenosis in both groups ( P>0.05).Stone recurrence occurred in 3 cases (2.7%) in the normal diameter group, all of which were removed by ERCP lithotomy. Stone recurrence occurred in 8 cases (2.9%) in the CBD dilated group, 7 were removed by ERCP stone extraction and 1 refused further treatment. Conclusion:It is safe and feasible to perform LC+LCBDE in patients with cholecystolithiasis complicating normal sized CBD stones.
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OBJECTIVE@#To retrospectively analyze the clinical characteristics and prognostic factors of patients with primary cutaneous lymphoma.@*METHODS@#The clinical data of 22 patients with primary cutaneous lymphoma admitted to Xinjiang Hotan District People's Hospital, Heji Hospital affiliated to Changzhi Medical College and the Fifth Medical Center of PLA General Hospital from January 2013 to June 2021 were retrospectively analyzed.@*RESULTS@#The incidence of primary cutaneous T cell and NK/T cell lymphoma was about 91.9/100 000, and the incidence of primary cutaneous B cell lymphoma was about 14.5/100 000. The overall survival (OS) of patients aged ≥65 years was significantly shorter than that of patients younger than 65 years (P <0.05). Patients with elevated β2-microglobulin (β2-MG) had shorter OS and progression-free survival (PFS) (both P <0.05). Patients who achieved complete/partial response after initial treatment had longer OS than those with stable or progressive disease (P <0.05). There were significant differences in OS and PFS among patients with different pathological types of primary cutaneous lymphoma that originated from T and NK/T cells, the OS and PFS of patients with mycosis fungoides were longer than those of patients with other pathological types (both P <0.05). In addition, disease stage might also affect the PFS of the patients (P =0.056).@*CONCLUSION@#The age, disease stage, β2-MG level, pathological type and remission state after treatment of the patients were related to the clinical prognosis.
Subject(s)
Humans , Prognosis , Retrospective Studies , Remission Induction , LymphomaABSTRACT
AIM: To study the clinical and radiologic features of patients with capecitabine neurotoxicity. METHODS: We performed a retrospective analysis and systematic review on the clinical and radiologic characteristics of all patients with capecitabine neurotoxicity reported in literature between 2003 and 2020. RESULTS: 24 cases including our patient were retrospectively analysed, with their clinical and radiologic features summarized. Their median age was 59 years old (ranges from 31 to 82 years old). Encephalopathy was the predominant clinical symptom affecting more than half (15/24, 63%) of the patients. This was followed by cerebellar ataxia (10/24, 42%). Amongst the patients who had magnetic resonance imaging(MRI) brain imaging performed, majority of them (18/23, 78%) had acute radiologic abnormalities. Leukoencephalopathy was the commonest radiologic abnormality seen in more than half of the patients (15/23,65%). Despite the preponderance of female patients in our study, there were no significant statistical differences in the clinical and radiologic features. Short term prognosis was excellent with complete resolution of neurologic symptoms observed in nearly all of the patients (22/23, 96%). CONCLUSION: Capecitabine-related neurotoxicity is an uncommon cause of toxic encephalopathy, with a predilection for females. Clinical features are non-specific, with encephalopathy being the commonest. Prognosis remains good with timely recognition, and cessation of capecitabine. Future research looking into other pathogenic pharmacogenetic processes should be conducted for further elucidation of these associations.
Subject(s)
Leukoencephalopathies , Neurotoxicity Syndromes , Humans , Female , Middle Aged , Adult , Aged , Aged, 80 and over , Capecitabine/adverse effects , Retrospective Studies , Antimetabolites, Antineoplastic/adverse effects , Leukoencephalopathies/chemically induced , Leukoencephalopathies/diagnostic imaging , Leukoencephalopathies/complications , Neurotoxicity Syndromes/diagnostic imaging , Neurotoxicity Syndromes/etiology , Magnetic Resonance ImagingABSTRACT
Aims: To describe and compare the clinical features of patients with acute metaldehyde toxicity from suicidal and accidental ingestion of metaldehyde, and to elucidate factors influencing early treatment and disposition. Methods: We undertook a systematic review and retrospective analysis of the clinical characteristics and outcomes of patients with acute toxicity from ingesting metaldehyde. Results: Twenty-one cases identified between 1965 and 2021 were analyzed. The median age was 32 years (range, 3-68 years), and two-thirds of patients experienced symptoms (14/21, 67%). In symptomatic patients, gastrointestinal symptoms were present in two-thirds (9/14, 64%), and half experienced neurologic complications (8/14, 57%); of those with neurologic complications, half experienced seizures (8/14, 57%). There were near-equal cases of accidental and suicidal poisoning. Those who attempted suicide were likelier to develop symptoms (90% versus 45%, P = 0.031), experience seizures (60% versus 18%, P = 0.049), require intensive care (50% versus 9%, P = 0.038), and suffer longer hospitalizations (13.3 days versus 2.9 days, P = 0.005), despite no statistically significant differences in the doses of metaldehyde consumed when compared against patients with accidental ingestion (9.04 g versus 2.03 g, P = 0.09). Conclusion: The circumstances in which metaldehyde is consumed heavily influence clinical symptoms and outcomes. Early and close observation for seizures and adopting a lowered threshold for escalation to the intensive care unit are recommended in patients attempting suicide even when the dose ingested cannot be determined at that time, which is common during the early phases of treatment.
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OBJECTIVE: To observe the effect of moxibustion treatment on the expression of Nogo-A, Nogo receptor (NgR), neurotrophin receptor p75 (p75NTR) and leucine rich repeat and Ig domain containing 1 (Lingo-1) in brain tissue of rats with cerebral ischemia/reperfusion injury (CI/RI), so as to analyze its mechanism underlying improvement of CI/RI. METHODS: Male SD rats were randomly divided into sham operation group (16 rats), model group (17 rats), NEP1-40 (extracellular peptide residues 1-40, a blocker targeting NgR) group (model+blocker, 17 rats) and moxibustion group (model+moxibustion, 17 rats). The CI/RI model was established by occlusion of the left middle cerebral artery (MCAO). Moxibustion was applied to "Baihui"(GV20), right "Quchi"(LI11) and "Zusanli"(ST36) for 20 min, once a day for 14 days, with 2 days' rest after the top 7 days' intervention. For rats of the NEP1-40 group, 30 µL PBS containing 18 µg NEP 1-40 was injected into the epidural inferior vena (L5-S1) via a polyvinyl chloride conduit. The neurological deficit state in each group was evaluated by Longa's 5-point scale and Feeney's 7-point scale of beam walking test (BWT). The cerebral infarct volume was assessed by 2,3,5-triphenyltetrazole chloride staining. The brain tissue between the central anterior and posterior sulcus was taken for observing the expression of NgR and Lingo-1 by fluorescence double-label method, and for determining the expression levels of Nogo-A, NgR, p75NTR and Lingo-1 mRNAs and proteins by real-time quantitative PCR and Western blot, respectively. RESULTS: After modeling, the Longa's score, infarct volu-me percent, expression levels of Nogo-A, NgR, Lingo-1 and p75NTR mRNAs and proteins were significantly increased (P<0.01) and BWT score was obviously decreased (P<0.01) in the model group relevant to the sham operation group. In comparison with the model group, the increase of Longa's score, infarct volume percentage, expression levels of Nogo-A, NgR, Lingo-1 and p75NTR mRNAs and proteins and decrease of BWT score in NEP1-40 and moxibustion groups were reversed (P<0.01) except Nogo-A protein in the NEP1-40 group. The effect of moxibustion was significantly superior to that of blocker NEP1-40 in redu-cing the infarct volume percentage, and down-regulating the expression of Nogo-A mRNA and protein, p75NTR mRNA and protein, NgR and Lingo-1 proteins (P<0.01, P<0.05). CONCLUSION: Moxibustion, similar to blocker NEP1-40 of NgR, can improve neurological dysfunction in CI/RI rats, which may be related to its functions in reducing cerebral infarction and down-regulating the activity of Nogo/neurotrophin receptor signaling pathway.
Subject(s)
Brain Ischemia , Electroacupuncture , Moxibustion , Reperfusion Injury , Animals , Brain Ischemia/genetics , Brain Ischemia/therapy , Cerebral Infarction , Male , Nogo Proteins/genetics , RNA, Messenger , Rats , Rats, Sprague-Dawley , Receptors, Nerve Growth Factor , Reperfusion Injury/genetics , Reperfusion Injury/therapy , Signal TransductionABSTRACT
BACKGROUND: This study aimed to describe the clinical features of patients with orbital apex syndrome (OAS) as a complication of herpes zoster ophthalmicus (HZO) and to identify factors associated with poor visual acuity outcomes. METHODS: We performed a systematic review and retrospective analysis of the clinical characteristics and outcomes of patients with OAS secondary to HZO reported in the literature over 42 years (1978-2020). RESULTS: We analysed 21 cases, 20 of which were identified in the literature, together with our patient. Their median age was 65 years, with equal involvement in both sexes. The median onset of OAS due to HZO was 10 days (range 1-28 days). The median time of treatment initiation was five days (range 1-21 days). All patients presented with reduced visual acuity, complete ophthalmoplegia, and ptosis. Most patients (17/21, 80.95%) were treated with systemic antiviral and corticosteroid therapy. Three (3/21, 14.29%) patients were immunocompromised. Recovery for ophthalmoplegia (19/21, 90.48%) and ptosis (16/21, 76.19%) was good. Half of the patients (9/18, 50%) showed poor vision recovery. Starting treatment more than 72 h after HZO onset (p = 0.045) was more likely to cause poor vision recovery. CONCLUSION: OAS is a rare, serious, and potentially late complication of HZO and continued observation up to and perhaps beyond four weeks is justifiable, if not encouraged. Early initiation of treatment with systemic antiviral and/or corticosteroids within 72 h of onset of HZO appears beneficial for the recovery of visual acuity.
Subject(s)
Blepharoptosis , Herpes Zoster Ophthalmicus , Ophthalmoplegia , Aged , Antiviral Agents/therapeutic use , Blepharoptosis/complications , Blepharoptosis/drug therapy , Female , Herpes Zoster Ophthalmicus/complications , Herpes Zoster Ophthalmicus/drug therapy , Humans , Male , Ophthalmoplegia/drug therapy , Ophthalmoplegia/etiology , Retrospective Studies , Syndrome , Vision Disorders/drug therapyABSTRACT
Protein O-GlcNAcylation is a post-translational modification that links environmental stimuli with changes in intracellular signal pathways, and its disturbance has been found in neurodegenerative diseases and metabolic disorders. However, its role in the mesolimbic dopamine (DA) system, especially in the ventral tegmental area (VTA), needs to be elucidated. Here, we found that injection of Thiamet G, an O-GlcNAcase (OGA) inhibitor, in the VTA and nucleus accumbens (NAc) of mice, facilitated neuronal O-GlcNAcylation and decreased the operant response to sucrose as well as the latency to fall in rotarod test. Mice with DAergic neuron-specific knockout of O-GlcNAc transferase (OGT) displayed severe metabolic abnormalities and died within 4-8 weeks after birth. Furthermore, mice specifically overexpressing OGT in DAergic neurons in the VTA had learning defects in the operant response to sucrose, and impaired motor learning in the rotarod test. Instead, overexpression of OGT in GABAergic neurons in the VTA had no effect on these behaviors. These results suggest that protein O-GlcNAcylation of DAergic neurons in the VTA plays an important role in regulating the response to natural reward and motor learning in mice.