Craniocerebral Magnetic Resonance Imaging Research Articles

Speech-language performance and comorbid disorders in children with perisylvian syndrome induced by viral encephalitis.

Viral encephalitis is one of the main causes of the perisylvian syndrome, which can cause damage to children's language-speech, feeding, and swallowing functions. Comprehensive assessment of language-speech and swallowing function and comorbidity research on these children will help children's rehabilitation workers to better understand the disease and strengthen the systematic management of comorbid disorders. To describe speech and language pathology and the occurrence of comorbid disorders in children with perisylvian syndrome induced by viral encephalitis. Twenty-two children with acquired perisylvian syndrome were recruited in this study. Language and speech functions, including oral motor function, swallowing function, language ability, and dysarthria were assessed in these patients. Craniocerebral magnetic resonance imaging (MRI), electroencephalogram examination, and intelligence evaluation were performed to determine brain lesions and comorbid disorders. All children exhibited different degrees of oral movement, dysphagia, and speech and language disorders. There was a significant difference between expressive and receptive language ability (P<0.05). There were 10, 8, and 12 children who had an intellectual disability, limb disability, and epilepsy, respectively. In addition to the damage of the peri-tegmental cortex found in MRI, thalamus lesions occurred in 19 cases and white matter involvement in six cases. Children with acquired perisylvian syndrome caused by viral encephalitis are characterized by persistent pseudobulbar dysfunction, speech and language impairment, and orofacial diplegia. They have a high probability of secondary epilepsy and are prone to motor and cognitive impairment, which need systematic management.

Comfortable Nursing in the Intraoperative MRI Evaluation Combined with Microsurgery in the Treatment of Functional Area Glioma

This study was aimed to investigate the application value of magnetic resonance imaging (MRI) scanning examination in the preoperative treatment of functional glioma and to analyze the application effect of nursing intervention in the operating room in the treatment of fiber surgery. In this study, 80 patients with functional glioma were included as research objects and randomly rolled into the control group (routine nursing) and the experimental group (comfort nursing intervention in the operating room), with 40 cases in each group. All patients underwent craniocerebral MRI plain scan plus enhanced scan before surgery. The levels of the heart rate, systolic blood pressure, diastolic blood pressure, interleukin-6 (IL-6), cortisol, and anxiety before and after the intervention in the two groups were compared when patients entered the operating room (T1), when anesthesia took effect (T2), at the end of surgery (T3), when patients regained consciousness after surgery (T4), and 1 day after surgery (T5). MRI showed that the main glioma sites were located in the basal ganglia region (26.25%), followed by the central region (20.00%) and the Broca region (17.5%). The levels of IL-6 at T2, T3, and T4 in the control group were 186.45 ± 64.55 ng/L, 287.68 ± 34.59 ng/L, and 488.69 ± 81.14 ng/L, respectively, which were inferior to those at T2 (167.44 ± 15.59 ng/L), T3 (186.25 ± 52.64 ng/L), and T4 (356.57 ± 48.22 ng/L) in the test group. The SAS score of the test group after intervention (45.38 ± 2.02) was lower than that of the control group (51.03 ± 3.65) ( P &lt; 0.05 ). The levels of cortisol in the test group (T2 (8.89 1.23 ng/L), T3 (9.23 1.25 ng/L), and T4 (11.78 1.27 ng/L) were lower than those in the control group (T2 (11.58 ± 2.48 ng/L), T3 (12.06 ± 2.82 ng/L), and T4 (13.04 ± 11.78)). In short, preoperative MRI scanning was beneficial to detect the location of glioma in functional area. Comfort nursing in the operating room can effectively relieve the anxiety and depression of glioma patients and improve the adverse psychological conditions of the patients.

Analysis of the positive rate of otitis media in 1-12 years old children based on brain MRI

Objective:To investigate the positive imaging rate of otitis media in children aged 1-12 years by analyzing the positive rate of otitis media suggested by cranial magnetic resonance imaging（MRI） images in children. Methods:By collecting the brain MRI images of children aged 1-12 in Department of Otolaryngology, Jinan children's Hospital from January 2014 to December 2020, the overall incidence of otitis media and mastoiditis was firstly determined, and then it was divided into 12 age groups according to age, each age group was split into boy and girl groups according to gender, each group was divided into left, right and bilateral groups, with the changes of otitis media and mastoiditis in the scanning field as the positive standard statistical analysis of the results. Results:Among 12 439 children in the study, 1321 cases were diagnosed with tympanitis, with a positive rate of 10.62%. Among them, 892 patients were male, with a positive rate of 67.52%, and 429 cases were female, with a positive rate of 32.48%. The positive rate of the male was higher than that of female children, 1.84 times higher than that of female children. The positive momentum in male and female children was negatively correlated with age （P<0.01）. The favorable rates of male children in the left ear, right ear, and both ears were higher than those in female children of the same age（P<0.05）. There was no difference in the positive rate of the left and right ear in children with tympanitis （P=0.76）. Conclusion:Craniocerebral MRI examination in children with tympanitis can clarify the inflammation of the middle ear cavity and the effusion in the mastoid air chamber. The positive rate of children at two years old showed a steep decline, which may be due to the acceleration of mastoid gasification, the change of tympanic environment, the increase of air chamber in the tympanic room, the evolution of air pressure could offset the negative pressure caused by poor Eustachian tube function, to reduce the incidence of tympanitis.

A novel de novo frameshift variation in the SON gene causing severe global developmental delay and seizures in a Chinese female.

With the rapid development of genetic detection technology, especially next-generation sequencing, identification of the aetiology of unexplained intellectual disabilities accompanied by seizures and other dysmorphic features has become possible. The purpose of our paper is to make a definitive diagnosis of a girl with neonatal hypotonia, severe global developmental delay, seizures and mild facial dysmorphism. The clinical data of the patient were retrospectively studied. Whole-exome sequencing was performed on a blood sample from the patient. Subsequently, Sanger sequencing was utilized for validation of variants and parental validation. The patient had hypotonia since the neonatal period. She showed a significant delay in physical and psychomotor development. She did not have any speech until the age of 2years and 6months. She had seizures that were easy to control with levetiracetam. The craniocerebral magnetic resonance imaging (MRI) then showed mild delayed myelination, enlarged bilateral ventricles and widened frontotemporal extracerebral space. Interictal video electroencephalogram (VEEG) was normal. She had esotropia and mild facial abnormalities with a flat nasal bridge and a short nose. She showed no abnormalities in the heart, genitourinary or skeletal systems. Whole-exome sequencing revealed a novel de novo variant c.5334_5335delAG (p. Arg1778Serfs*11) in the SON gene. Our paper reports a novel variant in the SON gene and provides a definitive diagnosis of a female with neonatal hypotonia, severe global developmental delay, seizures and mild facial abnormalities, which are symptoms consistent with Zhu-Tokita-Takenouchi-Kim syndrome (ZTTK syndrome).

Magnetic Resonance Image in Monitor and Diagnosis of Patients with Neuromyelitis Optica.

This study was aimed to investigate the craniocerebral magnetic resonance imaging (MRI) measurement and clinical characteristics of patients with neuromyelitis optica (NMO) and multiple sclerosis (MS). 50 patients with NMO (NMO group) and 50 patients with MS (MS group) were studied. The clinical manifestations, brain injury morphology, MRI signal characteristics, brain distribution characteristics, and related laboratory tests (serum aquaporin 4 [AQP4] antibody) were statistically analyzed. The results showed that the analysis of clinical manifestations of patients revealed that optic neuritis (37 cases) was the most common disease in NMO patients, and myelitis (16 cases) was more common in MS patients than NMO patients. There were significant differences in gender ratio, abnormal expression of brain MR1, positive serum AQP4-IgG, and other immune diseases and symptoms between the two groups (P < 0.05). When the lesions measured by MRI were located in the white matter area of the cerebral hemisphere, the image showed blurred edges and a relatively symmetrical distribution. When the lesions measured by MRI were located around the medulla oblongata, the lesions mainly involved the central gray matter and white matter of the spinal cord, with patchy and line-like long T1 and long T2 signals. Moreover, in the late stage of recurrence of spinal cord disease, severe spinal cord atrophy may occur. In conclusion, craniocerebral MRI measurement in NMO patients can provide more basis for the diagnosis and differential diagnosis of the disease, so as to improve the diagnostic level of NMO.

Craniocerebral Magnetic Resonance Imaging Features of Benign Paroxysmal Positional Vertigo under Artificial Intelligence Algorithm and the Correlation with Cerebrovascular Disease.

This research aimed to discuss the characteristics of benign paroxysmal positional vertigo (BPPV) and the correlation with cerebrovascular disease. An artificial intelligence algorithm under a parallel dual-domain concatenated convolutional neural network (PDDC-CNN) was proposed to process the images of magnetic resonance imaging (MRI). MRI, magnetic resonance angiography (MRA), and susceptibility weighted imaging (SWI) were performed on all 60 research objects with a 3.0 MRI scanner. The number of cases with cerebral microbleeds (CMBs), SWI image display of small veins, the number of lacunar infarctions, vertebral artery dominance, and vertebrobasilar morphology were observed in the two groups. The number of lacunar infarctions was 2.400 ± 3.358 and 0.672 ± 0.251, respectively, in the BBPV group with 30 cases and the control group with the other 30 cases. The positive rates of CMBs on SWI images were 48% and 27% in the BBPV group and the control group, respectively, and the average CMBs were counted as 1.670 ± 2.326 and 0.487 ± 0.865. CMBs were shown as round or oval lesions of conventional sequence deletion in the images with a diameter of less than 1.5 cm. SWI images of the BBPV group showed a significant increase in intracerebral small veins compared to those of the control group. The curvature of the vertebrobasilar artery in the BBPV group was significantly higher than that in the control group, and the curvature of the basilar artery was slightly higher than that in the control group. In conclusion, the MRI features of BPPV patients were related to their own microvascular lesions closely, and it was speculated that the cerebrovascular factors might play a dominant role in the early onset of BPPV.

A Chinese CADASIL family with p.R578C mutation at exon 11 of the NOTCH3 gene

ObjectiveTo analyze one clinical case of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy(CADASIL), and to perform analysis of the related gene mutation for the proband and her family. MethodsAnalysis of clinical data from the patient diagnosed with CADASIL, including clinical manifestations, blood test results and brain imaging results, followed by high-throughput sequencing of blood samples. Pathogenicity assessment of the gene mutation, and first generation verification were performed on some family members according to genetic variation interpretation standards and guidelines of the American College of Medical Genetics and Genomics (ACMG). ResultsOnset of the proband occurred younger than 50-years-old with recurrent migraine attacks and positive family history of migraine and stroke, but without risk factors for cerebrovascular diseases. The craniocerebral magnetic resonance imaging (MRI) results showed diffusive white matter lesions and thus clinically met criteria for CADASIL diagnosis. NOTCH3 gene analysis showed a p.R578C mutation (1732 C > T) at the11th exon on chromosome 19 of the proband and some family members. ConclusionsNOTCH3 mutation is related to CADASIL. In this study, we observed a rather rare familial NOTCH3 mutation in China. This report further support the mutation site is pathogenic.

Clinical characteristics and elevated ProGRP and positive oligoclonal bands of 13 Chinese cases with anti-GABABR encephalitis.

To improve the clinical understanding of anti-gamma-aminobutyric-acid B receptor encephalitis (anti-GABABR encephalitis) by analyzing 13 cases. We retrospectively studied demographic and clinical features including clinical symptoms, serum/cerebrospinal fluid (CSF) laboratory findings (including antibody test), brain magnetic resonance imaging (MRI), electroencephalogram (EEG), treatment plan, and treatment effect for 13 patients with a definitive diagnosis of anti-GABABR encephalitis. Seven patients (53.8%, 7/13) were complicated with lung cancer. Epileptic seizures were the most common symptoms at onset in 11 patients (84.6%, 11/13). All patients had seizures in the course of the disease. Abnormalities in craniocerebral MRI examination, including hippocampus, occipital lobe, insular lobe, were found in six of nine tested patients, and EEG abnormalities were found in seven out of nine tested patients. Elevated pro-gastrinreleasingpeptide (ProGRP) levels were found in 70% of patients with a median value of 490.10pg/ml; and CSF oligoclonal bands were positive for 4 of 10 tested cases. However, there were no significant differences in modified Rankin Scale (mRS) between the ProGRP or CSF oligoclonal band positive and negative groups at admission and follow-up (p>.05). The value between SCLC and non-SCLC subgroup was significantly different (p<.05). Ten patients received immunotherapy (three patients refused treatment). After immunotherapy, the frequency of seizures was significantly reduced. There was a significant difference in mRS between admission and after treatment (p<.05). The average survival time after onset was 27.7months. Epilepsy is the most common clinical manifestation of Anti-GABABR encephalitis. The prognosis of anti-GABABR encephalitis is poor. Section of anti-GABABR encephalitis patients have higher level of serum ProGRP and positive GSF oligoclonal bands. Elevated ProGRP or positive CSF oligoclonal bands with classic clinical features can potentially help to improve early recognition of anti-GABABR encephalitis.

Observation of the Sedative Effect of Dexmedetomidine Combined With Midazolam Nasal Drops Before a Pediatric Craniocerebral MRI.

This study aimed to investigate the sedative effect of dexmedetomidine combined with midazolam nasal drops before a pediatric craniocerebral magnetic resonance imaging (MRI). Eighty children who needed an MRI examination were enrolled in the present study and randomly divided into 2 groups: the observation group (dexmedetomidine combined with midazolam nasal drops) and the control group. After the children were given the medication, their heart rate, blood oxygen saturation (SpO2), and respiratory rate were continuously monitored and the adverse reactions such as nausea and vomiting, cough, restlessness, heart rate slowdown, and respiratory depression were observed. The difference in the onset time between the 2 groups was not statistically significant (P > 0.05), but the duration was significantly longer in the observation group than in the control group (P < 0.01) and the examination success rate were significantly higher in the observation group than in the control group (P < 0.05). The protocol of 3 μg/kg of a dexmedetomidine injection combined with 0.3 mg/kg of midazolam nasal drops is safe, easy to operate, and has a high success rate, which is worthy of clinical promotion.

The expression and clinical significance of miRNA-183 in cerebral ischemia-reperfusion injury patients with cerebral small vessel disease.

BackgroundTo investigate the expression and clinical significance of micro (mi)RNA-183 in cerebral ischemia-reperfusion injury (CIRI) in patients with cerebral small vessel disease (CSVD).MethodsA total of 138 patients with CSVD complicated with CIRI admitted to our hospital from May 2018 to May 2019 were selected and divided into the CIRI group (138 cases of patients with cerebral vascular disease complicated with CIRI) and the control group [60 cases with no abnormalities in cranial magnetic resonance imaging (MRI) in healthy volunteers]; the results of craniocerebral MRI were subsequently recorded. The serum levels of miRNA-183 were detected by quantitative real-time polymerase chain (RT-qPCR), and the levels of interleukin-6 (IL-6), IL-8, IL-1β, and tumor necrosis factor-α (TNF-α) were determined by enzyme-linked immunosorbent assay (ELISA). A correlation analysis of serum miRNA-183 level and imaging lesion characteristics in patients with CSVD was also conducted.ResultsRT-qPCR showed that the peripheral blood miRNA-183 level in the CIRI group was increased compared to that in the control group; the level of miRNA-183 in the control group was 30.03±6.32, while the level of miRNA-183 in the CIRI group was 36.78±10.11, which was a statistically significant difference (t=2.475, P<0.05). Compared with the control group, the patient levels of TNF-α, IL-6, IL-8, and IL-1β in the CIRI group were significantly increased (P<0.05). Correlation analysis showed that the serum miRNA-183 level in the CIRI group was positively correlated with an increase of imaging lesions (r=0.997, P<0.05).ConclusionsThe level of miRNA-183 in CIRI patients with CSVD was higher than that of controls, and the level of miRNA-183 was positively correlated with the increase of imaging lesions.

The clinical research of serum glial fibrillary acidic protein combined with craniocerebral MRI in neonatal hypoxic-ischemic encephalopathy

Objective To explore the relationship between serum glial fibrillary acidic protein (GFAP) level and neonatal hypoxic-ischemic encephalopathy (HIE), and to verify whether GFAP combined with craniocerebral magnetic resonance imaging (MRI) can more accurately evaluate the prognosis of HIE. Methods We selected HIE children who hospitalized in the department of neonatology, the affiliated hospital of Inner Mongolia Medical University from January 2017 to December 2017, and full-term newborns without brain injury who were hospitalized in the same period. Serum samples were taken for GFAP detection on the 1st, 3rd, 7th day after birth of HIE and the 3rd day after birth of full-term newborns without brain injury. All the subjects completed craniocerebral MRI examination and followed up. At the same time, the correlation between GFAP level and the severity of brain MRI was evaluated. Results ⑴ The level of serum GFAP in HIE group on the 3rd day after birth [(5.54±1.30)ng/ml] was significantly higher than that in control group [(3.38±0.31)ng/ml] (P 0.05); there was significant difference between sequelae group [(6.93±1.29)ng/ml] and non-sequelae group [(4.91±0.77)ng/ml] on the 7th day (P 0.05), and there were significant differences on day 7 (P<0.05). Conclusions It is speculated that the increase of serum GFAP level in HIE newborns is related to the severity and prognosis of the disease, and is positively related to the results of craniocerebral MRI examination.Detecting the changes of serum GFAP in HIE newborns is helpful to determine the severity of the disease and evaluate the prognosis of the children. Combining GFAP with craniocerebral MRI may improve the accuracy of the judgment. Key words: Glial fibrillary acidic protein; Magnetic resonance imaging; Hypoxia-ischemia, brain; Infant, newborn, diseases

Characteristic Analysis and Literature Review of Hereditary Spinocerebellar Ataxia With Lumbar Spondylolisthesis and Valvular Prolapse

Spinocerebellar ataxia (SCA) is an autosomal dominant disease with high genetic heterogeneity, which cannot be cured until now. According to clinical manifestations or genetic pathology classification, SCA types 1 to 47 have been characterized so far, and the pathogenic genes of 28 SCA types have been identified. The clinical manifestations of the disease are diverse and easy to be misdiagnosed. This study aims to describe the family characteristics, specific clinical manifestations and genotyping of SCA patients. Magnetic resonance imaging (MRI) was used to check the atrophy of the brain and spinal cord. The lumbar spondylolisthesis was examined by computed tomography (CT). The possible influencing factors were analyzed by questioning each member of the patient’s family, especially the persons with the disease, to draw the genetic genealogy. Relevant literatures were searched to compare differences in genotypes between the patient and similar clinical manifestations. Craniocerebral MRI showed that cerebellar sulcus widened and deepened, vermis atrophy; enlargement of the cistern around the brainstem; cerebral cortex atrophy, furrow, fissure widen. Lumbar CT showed L3 spondylolisthesis slightly to the right. Genetic genealogy showed that the children of the patients still had the disease, and the children of the patients without the disease were all normal, which is consistent with the autosomal dominant genetic law. Compared with the literature, the patient had the same clinical manifestations as Machado’s disease: convex eyes, dysarthria, terminal muscles atrophy, ataxia gait, weakened tendon reflex, and arched foot. The same clinical manifestations of SCA40 included ataxia, wide-based gait, poor range discrimination and rotation movement disorder, but there were also many discrepancies. The patient’s lumbar spondylolisthesis and valvular prolapse were not present in any of the previous types. In conclusion, craniocerebral MRI and gene sequencing can help distinguish and diagnosis the subtypes of SCA; whether this patient is a new subtype with lumbar spondylolisthesis and heart valve prolapse needs further study; this genealogy supports that through eugenics dominant genetic diseases being passed on to the offspring can be avoided. J Neurol Res. 2019;9(4-5):81-88 doi: https://doi.org/10.14740/jnr544

The Degree of Middle and Lower Clivus Invasion by Chordoma is Linked to Patient Prognosis Via Ki-67 Value

The aim of this study was to discuss the relationship between Ki-67 values and the degree to which chordoma invade the clivus and to certify that the prognosis of chordoma is worse when it invades the middle and lower clivus than when it does not. We collected 56 cases of first-time chordoma illness in which patients received no treatment before surgery. Patients underwent craniocerebral magnetic resonance imaging and skull-base 3-dimensional computed tomography scans before the operation. We divided patients into 2 groups depending on the extent to which the middle and lower clivus were invaded. We classified patients with chordoma that did not significantly invade the middle and lower clivuses into a "noninvasive" group and the others into an "invasive" group. Ki-67 values were extracted from the pathological report after surgery. We use an independent χ2 test to indicate that Ki-67 values for the invasive group were higher than those for the noninvasive group. We grouped the data and did a statistical analysis. We found that the Ki-67 values are >5% for most patients in whom chordoma have eroded the middle-lower clivus, whereas it is ≤5% for patients in whom the middle-lower clivus region has not been invaded. Therefore, there is a correlation between Ki-67 value and the region of chordoma invading the clivus. Statistical analysis revealed that Ki-67 values when the chordoma invaded the middle and lower clivus were significantly higher than when it did not. Thus, we can conclude that the prognosis is worse when chordoma invade the middle and lower clivus.

Fever, unilateral convulsion status, disturbance of consciousness

There was a 6-years-old girl who was hospitalized for four episodes of convulsions within four hours . On admission, the main manifestations of the patient were unilateral convulsion status, fever and disturbance of consciousness.After improvement of consciousness, physical examination revealed hemiplegia on the convulsive side.Viral encephalitis was considered at admission.However, there were no abnormalities in routine and biochemical examinations of cerebrospinal fluid(CSF), and there were no abnormalities in immune antibodies and pathogen high-throughput sequencing of CSF, which excluded central nervous system infection.According to the craniocerebral magnetic resonance imaging, extensive edema in the right cerebral hemisphere was demonstrated.Diagnosis was considered to be idiopathic hemiconvulsion hemiplegia syndrome(IHHS). The antiepileptic drug was adjusted as phenobarbital, and the seizures were reduced.But one month later, intractable epilepsy occurred, and the final diagnosis was idiopathic hemiconvulsion-hemiplegia-epilepsy syndrome(IHHES). The clinical manifestations were fever, unilateral convulsion status, and disturbance of consciousness.The diagnosis should be combined with CSF examination and imaging characteristics and other considerations.IHHS may develop to IHHES in the later stage. Key words: Fever; Convulsion status; Disturbance of consciousness; Hemiconvulsion; Hemiplegia; Epilepsy

Characteristic Analysis and Literature Review of Hereditary Spinocerebellar Ataxia With Lumbar Spondylolisthesis and Valvular Prolapse

Spinocerebellar ataxia (SCA) is an autosomal dominant disease with high genetic heterogeneity, which cannot be cured until now. According to clinical manifestations or genetic pathology classification, SCA types 1 to 47 have been characterized so far, and the pathogenic genes of 28 SCA types have been identified. The clinical manifestations of the disease are diverse and easy to be misdiagnosed. This study aims to describe the family characteristics, specific clinical manifestations and genotyping of SCA patients. Magnetic resonance imaging (MRI) was used to check the atrophy of the brain and spinal cord. The lumbar spondylolisthesis was examined by computed tomography (CT). The possible influencing factors were analyzed by questioning each member of the patient’s family, especially the persons with the disease, to draw the genetic genealogy. Relevant literatures were searched to compare differences in genotypes between the patient and similar clinical manifestations. Craniocerebral MRI showed that cerebellar sulcus widened and deepened, vermis atrophy; enlargement of the cistern around the brainstem; cerebral cortex atrophy, furrow, fissure widen. Lumbar CT showed L3 spondylolisthesis slightly to the right. Genetic genealogy showed that the children of the patients still had the disease, and the children of the patients without the disease were all normal, which is consistent with the autosomal dominant genetic law. Compared with the literature, the patient had the same clinical manifestations as Machado’s disease: convex eyes, dysarthria, terminal muscles atrophy, ataxia gait, weakened tendon reflex, and arched foot. The same clinical manifestations of SCA40 included ataxia, wide-based gait, poor range discrimination and rotation movement disorder, but there were also many discrepancies. The patient’s lumbar spondylolisthesis and valvular prolapse were not present in any of the previous types. In conclusion, craniocerebral MRI and gene sequencing can help distinguish and diagnosis the subtypes of SCA; whether this patient is a new subtype with lumbar spondylolisthesis and heart valve prolapse needs further study; this genealogy supports that through eugenics dominant genetic diseases being passed on to the offspring can be avoided. J Neurol Res. 2019;9(4-5):81-88 doi: https://doi.org/10.14740/jnr544

Association of miR-182 expression in amniotic fluid with intrauterine infection and brain injury in premature infants.

Changes of micro-ribonucleic acid-182 (miR-182) level in cases of intrauterine infection were investigated to explore the association between miR-182 level change and brain injury in premature infants. A total of 257 preterm infants born in obstetrics department of Jinan Maternity and Child Care Hospital from February 2015 to February 2017 were enrolled in this study. These preterm infants were divided into infected group (n=113) and uninfected group (n=144) based on pathological diagnosis results. Quantitative polymerase chain reaction (qPCR) was employed to detect miR-182 level in amniotic fluid. Bregmatic sagittal and coronal plus lateral fontanel craniocerebral ultrasound, craniocerebral computed tomography (CT) and craniocerebral magnetic resonance imaging examinations were conducted in these preterm infants within one week after birth, and the results were recorded. The relationship between intrauterine infection and brain injury in premature infants was analyzed, and the association of miR-182 level with brain injury was explored. According to pathological diagnoses, brain injury was found in 61 of 113 infants in the infected group, with an incidence rate of 54.0%; and 28 of 144 infants in uninfected group, with an incidence rate of 19.4%; among them, 3 had placental infection caused by intrauterine infection in pregnant women, and all preterm infants had brain damage. Risk value of brain injury in premature infants due to intrauterine infection was hazard ratio (HR) = 2.2611, χ2=33.798, P<0.02. Infected group had a higher miR-182 level in comparison with uninfected group, and the difference in miR-182 level between infected group and uninfected group was statistically significant (P<0.05). Intrauterine infection can lead to an increase in miR-182 level; growth in miR-182 level is closely related to brain injury in premature infants.

Cranial Reconstruction Using Bioabsorbable Calcified Triglyceride Bone Cement

We report our experience on 6 cases of cranial reconstruction using bioabsorbable calcified triglyceride KRYPTONITE Bone Cement (Doctors Research Group). Six patients underwent cranial reconstruction during the surgical removal of a supratentorial tumor between September 2008 and November 2009 at our department. In 5 patients, we performed the cranial reconstruction using KRYPTONITE Bone Cement and cranial fixations; in the remaining patient, we avoided cranial fixation systems or other bone sutures to obtain good aesthetic results in the frontal supraorbital region. Preoperatively and 7 days and 12 months after surgery, patients were assessed using craniocerebral magnetic resonance imaging and computed tomography (CT). We observed that this bone cement was an injectable liquid for up to 8 minutes after mixing, it became adhesive at 8 to 15 minutes, and it was then shaped for use. Brain and dural reconstructions were not protected when this bone cement was being poured into the craniotomy site because of the minimal exothermal reaction. After 8 minutes, additional expansion is limited to 10%; therefore, we took heightened awareness of the amount of cement needed to fill the bone defect. In all patients, postoperative craniocerebral CT scanning, at 7 days, showed perfect alignment of the craniotomical bone and optimal filling of bone defects. No complications occurred, and aesthetic result was good. Twelve months after surgery, craniocerebral CT scanning showed bioabsorbability and osteoconductivity of this cement. KRYPTONITE Bone Cement is a nonthermal conducting, radiopaque, nonmagnetic, lightweight, simple to prepare, and easily applicable and molded material. Moreover, it has adhesive, bioabsorbable, and osteoconductive properties. To our knowledge, we present the first case of cranial reconstruction using this cement without cranial fixation systems.

Neurofibromatosis type 2 and auditory brainstem implantation

Neurofibromatosis type 2 and auditory brainstem implantation