Parasitic meningoencephalitis presents several etiologies which sometimes depend on their geographical location. They require thorough blood and cerebrospinal fluid check-up for directing an efficient treatment. Clini...Parasitic meningoencephalitis presents several etiologies which sometimes depend on their geographical location. They require thorough blood and cerebrospinal fluid check-up for directing an efficient treatment. Clinicians and radiologists are constantly looking for specific signs that could point to a particular etiology. The meningoencephalitis caused by Human African Trypanosomiasis (HAT) due to Trypanosoma brucei gambiense (TG) is a rare disease characterized by a slow progression, over years sometimes. Its non-specific presentation either clinically or in imaging can lead to misdiagnosis and thus, delay the treatment. However, involvement of the optic tracts seems to be characteristic of this condition, on old data from animal experimentation and recent high-field MRI data. MRI is the best current technique to explore the brain, cranial nerves, and visual pathways. In this article, we are going to present two observations of meningoencephalitis caused by HAT and then discuss some specific aspects of this neglected and re-emerging disease.展开更多
AIM: To investigate the diffusion changes in both the optic nerve and optic tract in orbital space-occupying lesion patients with decreased visual acuity, and its clinical significance using probabilistic diffusion tr...AIM: To investigate the diffusion changes in both the optic nerve and optic tract in orbital space-occupying lesion patients with decreased visual acuity, and its clinical significance using probabilistic diffusion tractography(PDT). METHODS: Twenty patients with orbital space-occupying lesions and 25 age-and gender-matched healthy persons were included. All patients and controls underwent routine orbital magnetic resonance imaging and diffusion tensor imaging(DTI), using a 3.0 T magnetic resonance scanner(Trio Tim Siemens). After the image data were preprocessed, each DTI parameters of the optic nerve and optic tract was obtained by PDT, including fractional anisotropy(FA), mean diffusivity(MD), axial diffusivity(AD) and radial diffusivity(RD). The asymmetry index(AI) of each parameter was calculated. Compared the parameters of the affected side optic nerve and ipsilateral optic tract with the contralateral side by paired sample t-test;compared AI of parameters of optic nerve and optic tract between the patient group and the control group by independent sample t-test. Patients were divided into threesubgroups according to the low vision grade standard of WHO, compared the FA and AI of FA between the three subgroups by single factor variance analysis. RESULTS: The affected side optic nerve presented significantly decreased FA, increased MD, AD, and RD values compared to the unaffected side(P<0.05). The AI of FA, MD, AD, and RD of optic nerve in the patients was significantly higher than that of the controls(P<0.05). The comparison results of the optic tract showed that there was no significant difference between the patient group and control group in terms of the bilateral optic tracts in patients(P>0.05). The AIs of the FA value of the optic nerve in the eyesight <0.1 subgroup was significantly higher than that in the other groups(P<0.05). CONCLUSION: FA, MD, AD, and RD of the affected side optic nerve of the orbital space-occupying lesions have significantly changed, the FA value is the most sensitive. The PDT could be a useful tool to provide valid quantitative markers of optic nerve injuries and evaluate the severity of orbital diseases, which other examinations cannot be acquired.展开更多
Carnosine is a dipeptide that scavenges free radicals, inhibits infammation in the central nervous system, and protects against ischemic and hypoxic brain damage through its anti-oxidative and anti-apoptotic actions. ...Carnosine is a dipeptide that scavenges free radicals, inhibits infammation in the central nervous system, and protects against ischemic and hypoxic brain damage through its anti-oxidative and anti-apoptotic actions. Therefore, we hypothesized that carnosine would also protect against white matter damage caused by subcortical ischemic injury. White matter damage was induced by right unilateral common carotid artery occlusion in mice. The animals were treated with 200, 500 or 750 mg/kg carnosine by intraperitoneal injection 30 minutes before injury and every other day after injury. Then, 37 days later, Klfiver-Barrera staining, toluidine blue staining and immunofluorescence stain- ing were performed. Carnosine （200, 500 mg/kg） substantially reduced damage to the white matter in the corpus callosum, internal capsule and optic tract, and it rescued expression of myelin basic protein, and alleviated the loss of oligodendrocytes. However, carnosine at the higher dose of 750 mg/kg did not have the same effects as the 200 and 500 mg/kg doses. These findings show that carnosine, at a particular dose range, protects against white matter damage caused by chronic cerebral ischemia in mice, likely by reducing oligodendroglial cell loss.展开更多
Human African Trypanosomiasis (HAT) or sleeping thickness is a forest and rural disease;where agriculture is the main activity. It is a chronic and lethal disease without treatment. HAT is caused by two parasites;Tryp...Human African Trypanosomiasis (HAT) or sleeping thickness is a forest and rural disease;where agriculture is the main activity. It is a chronic and lethal disease without treatment. HAT is caused by two parasites;Trypanosoma Brucei Gambiense (gTB) and Trypanosoma Brucei Rhodesiense (rTB) transmitted to humans by the tsetse fly. It is endemic condition in Africa between the 15° north latitude and the 20° south latitude. It is reported outside this area in travelers who stayed in endemic zone. Infection by gTB is wider and more frequent (98%) than that by rTB (2%). The Democratic Republic of Congo is the most affected country with more than 75% of reported cases. The geographical distribution is not homogeneous. There are more affected regions in a zone called “foci” which represents areas favorable to the development of the vector. Its diagnosis and treatment are very important because of its social and economic impact at both the individual and community levels. Promising molecules including fexinidazole are currently undergoing testing. Nowadays populations move more and more easily but the discovery of this disease in daily neuroradiological practice is exceptional. We propose in this paper through two observations, reminders on epidemiological, clinical and MRI features of HAT. It typically performs the edematous, bilateral and diffuse encephalitis. It is important to distinguish these aspects from the arsenic-induced encephalitis that may occur during treatment. Only vector control allows eradicating this disease. WHO has set targets elimination of HAT as a public health problem for 2020 deadline.展开更多
文摘Parasitic meningoencephalitis presents several etiologies which sometimes depend on their geographical location. They require thorough blood and cerebrospinal fluid check-up for directing an efficient treatment. Clinicians and radiologists are constantly looking for specific signs that could point to a particular etiology. The meningoencephalitis caused by Human African Trypanosomiasis (HAT) due to Trypanosoma brucei gambiense (TG) is a rare disease characterized by a slow progression, over years sometimes. Its non-specific presentation either clinically or in imaging can lead to misdiagnosis and thus, delay the treatment. However, involvement of the optic tracts seems to be characteristic of this condition, on old data from animal experimentation and recent high-field MRI data. MRI is the best current technique to explore the brain, cranial nerves, and visual pathways. In this article, we are going to present two observations of meningoencephalitis caused by HAT and then discuss some specific aspects of this neglected and re-emerging disease.
基金Supported by the National Natural Science Foundation of China (No.81471649)Beijing Municipal Science and Technology Commission (No. Z171100000117001)
文摘AIM: To investigate the diffusion changes in both the optic nerve and optic tract in orbital space-occupying lesion patients with decreased visual acuity, and its clinical significance using probabilistic diffusion tractography(PDT). METHODS: Twenty patients with orbital space-occupying lesions and 25 age-and gender-matched healthy persons were included. All patients and controls underwent routine orbital magnetic resonance imaging and diffusion tensor imaging(DTI), using a 3.0 T magnetic resonance scanner(Trio Tim Siemens). After the image data were preprocessed, each DTI parameters of the optic nerve and optic tract was obtained by PDT, including fractional anisotropy(FA), mean diffusivity(MD), axial diffusivity(AD) and radial diffusivity(RD). The asymmetry index(AI) of each parameter was calculated. Compared the parameters of the affected side optic nerve and ipsilateral optic tract with the contralateral side by paired sample t-test;compared AI of parameters of optic nerve and optic tract between the patient group and the control group by independent sample t-test. Patients were divided into threesubgroups according to the low vision grade standard of WHO, compared the FA and AI of FA between the three subgroups by single factor variance analysis. RESULTS: The affected side optic nerve presented significantly decreased FA, increased MD, AD, and RD values compared to the unaffected side(P<0.05). The AI of FA, MD, AD, and RD of optic nerve in the patients was significantly higher than that of the controls(P<0.05). The comparison results of the optic tract showed that there was no significant difference between the patient group and control group in terms of the bilateral optic tracts in patients(P>0.05). The AIs of the FA value of the optic nerve in the eyesight <0.1 subgroup was significantly higher than that in the other groups(P<0.05). CONCLUSION: FA, MD, AD, and RD of the affected side optic nerve of the orbital space-occupying lesions have significantly changed, the FA value is the most sensitive. The PDT could be a useful tool to provide valid quantitative markers of optic nerve injuries and evaluate the severity of orbital diseases, which other examinations cannot be acquired.
基金funded by the National Natural Science Foundation of China,No.81402904the Foundation of Shanghai Jiao Tong University School of Medicine,No.13XJ22001+1 种基金the Foundation of Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,No.13YJ11a grant from the Science and Technology Commission of Shanghai Municipality of China,No.13ZR1426900,15411963900
文摘Carnosine is a dipeptide that scavenges free radicals, inhibits infammation in the central nervous system, and protects against ischemic and hypoxic brain damage through its anti-oxidative and anti-apoptotic actions. Therefore, we hypothesized that carnosine would also protect against white matter damage caused by subcortical ischemic injury. White matter damage was induced by right unilateral common carotid artery occlusion in mice. The animals were treated with 200, 500 or 750 mg/kg carnosine by intraperitoneal injection 30 minutes before injury and every other day after injury. Then, 37 days later, Klfiver-Barrera staining, toluidine blue staining and immunofluorescence stain- ing were performed. Carnosine （200, 500 mg/kg） substantially reduced damage to the white matter in the corpus callosum, internal capsule and optic tract, and it rescued expression of myelin basic protein, and alleviated the loss of oligodendrocytes. However, carnosine at the higher dose of 750 mg/kg did not have the same effects as the 200 and 500 mg/kg doses. These findings show that carnosine, at a particular dose range, protects against white matter damage caused by chronic cerebral ischemia in mice, likely by reducing oligodendroglial cell loss.
文摘Human African Trypanosomiasis (HAT) or sleeping thickness is a forest and rural disease;where agriculture is the main activity. It is a chronic and lethal disease without treatment. HAT is caused by two parasites;Trypanosoma Brucei Gambiense (gTB) and Trypanosoma Brucei Rhodesiense (rTB) transmitted to humans by the tsetse fly. It is endemic condition in Africa between the 15° north latitude and the 20° south latitude. It is reported outside this area in travelers who stayed in endemic zone. Infection by gTB is wider and more frequent (98%) than that by rTB (2%). The Democratic Republic of Congo is the most affected country with more than 75% of reported cases. The geographical distribution is not homogeneous. There are more affected regions in a zone called “foci” which represents areas favorable to the development of the vector. Its diagnosis and treatment are very important because of its social and economic impact at both the individual and community levels. Promising molecules including fexinidazole are currently undergoing testing. Nowadays populations move more and more easily but the discovery of this disease in daily neuroradiological practice is exceptional. We propose in this paper through two observations, reminders on epidemiological, clinical and MRI features of HAT. It typically performs the edematous, bilateral and diffuse encephalitis. It is important to distinguish these aspects from the arsenic-induced encephalitis that may occur during treatment. Only vector control allows eradicating this disease. WHO has set targets elimination of HAT as a public health problem for 2020 deadline.
