Correlation of diseased region and area with neglect and other neuropsychological dysfunctions in patients with cerebral infarction

BACKGROUND: Previous studies reported that frontal-temporal-parietal-occipital pathological changes and diseased range in the right cerebral hemisphere were closely correlated with neglect. But studies on the correlation of neglect with diseased region and area in patients who suffer from initial attack of single focus of cerebral infarction (CI) in left and right cerebral hemispheres are few. OBJECTIVE: To observe the status of neglect in patients who suffer from single focus of CI in cerebral hemisphere, and analyze the correlation of neglect with diseased region and area of CI. DESIGN: Case analysis. SETTING: Treatment Center for Cardiocerebrovascular Disease, Second Hospital of Xiamen city; Department of Neurology, First Hospital Affiliated to Baotou Medical College. PARTICIPANTS: All the CI patients hospitalized in the Department of Neurology, First Hospital Affiliated to Baotou Medical College from June 1998 to May 2001 were retrieved. Inclusive criteria: ① Patients who suffered from initial attack of CI, which was confirmed by skull CT or MRI within 24 hours after onset and presented single focus in cerebral hemisphere. ② be conscious and could cooperate in the examination. ③ did not receive formal education, but could do accounts and some simple writing and reading. ④Patients with homonymous hemianopia were excluded through the examination of perimeter. ⑤ Informed consents were obtained from all the patients. Among 67 patients who met the inclusive criteria, 33 suffered from CI in the left cerebral hemisphere and 34 in the right cerebral hemisphere. METHODS: ① Patients received neglect supplement examination and Chinese aphasia examination within 2.5 to 3 months after the attack of CI . The diagnostic criteria of neglect in the tests of line cancellation, line bisection and copying the figures were as follows: In the line cancellation test based on the method of Albert, patients who could not cancel one or more lines were regarded as abnormal. In the line bisection test based on the method of Peter, patients who left deviated 1.16% or right deviated 2.51% were regarded as abnormal. In the test of copying the figures, round-shape, square, cruciform and other shapes were asked to be copied, defect appeared in the figure was regarded as abnormal. The diagnostic criteria of aphasia were according to the diagnostic method of Chinese aphasia examination and type identification flow-sheet of aphasia. Infarct area was calculated based on Palisino formula: infarct area=π/6×the longest diameter of infarct area×the widest diameter of infarct area×the number of CT positive layer. ② Chi-square test was used for comparing the difference of measurement data. MAIN OUTCOME MEASURES: Diseased region and area of CI and their correlations with neglect. RESULTS: Sixty-seven patients were involved in result analysis. ① The correlation of the occurrence of neglect with the diseased regions of CI: Neglect was not found in 33 patients with CI in left cerebral hemisphere, but was found in 7 of 34 patients with CI in right cerebral hemisphere. The diseased regions involved right temporoparietal region, temporal-parietal-occipital region, frontal-temporal-parietal region, frontal-temporal-parietal-occipital region, temporoparietal basal nucleus, basal nucleus and dorsal caudate putamen. ②The correlation of the occurrence of neglect with diseased area: infarct area ≤ 30 cm3 was found in 2 patients with neglect (12.5%), infarct area at 31 to 60 cm3 in 1 patient with neglect (14.3%),infarct area ≥ 61 cm3 in 4 patients with neglect (36.4%). There was no significant difference in infarct area among groups (P > 0.05). CONCLUSION: ① Right cerebral hemisphere takes advantage in spatial attention. ② Neglect is more possibly caused by the combined pathological changes in temporal and parietal lobe. Temporal and parietal lobes may not cause neglect independently, but the occurrence of neglect is not directly correlated with infarct area.

Correlation between serum fructosamine and hyperglycemia in patients with acute cerebrovascular disease

BACKGROUND:Diabetes mellitus is one of the risk factors in patients with acute cerebral disease,and always leads to stroke or get it worse.There is often a high level of blood glucose in those patients with diabetes mellitus and cerebral disease,but it is hard to distinguish from both kinds of hyperglycemia.Serum fructosamine is said to be correlated with blood glucose.OBJECTIVE:To explore the relationship between serum fructosamine and blood glucose in patients with acute cerebrovascular disease.DESIGN:A case-controlled study.SETTINGS:Department of Clinical Laboratory,Health Department for Cadres and Department of Neurology of Affiliated Hospital,Qingdao University Medical College.PARTICIPANTS:Forty-eight inpatients and outpatients with cerebrovascular diseases were selected from the Department of Neurology,Affiliated Hospital of Qingdao University Medical College from December 2004 to April 2005.All the patients were confirmed with CT and MRI.There were 25 patients with diabetes mellitus secondary cerebrovascular diseases,who met the diagnostic standards of diabetes mellitus set by WHO,including 12 males and 13 females with an average of(60±8)years old,the course of diabetes mellitus ranged from 1 to 21 years..The other 23 patients had no diabetes mellitus(without diabetes mellitus group),including 14 males and 9 females with an average of(62±6)years old.Meanwhile,another 50 healthy physical examinees in the hospital were selected as control group,including 26 males and 24 females with the average age of(62±5)years old.Informed content was obtained from all the participants.METHODS:Venous blood was drawn from all the participants,and content of blood glucose was assayed by means of glucose oxidase,and the concentration of serum fructosamine was determined by nitroblue tetrazolium colorimetric method.Comparison between groups was performed by the analysis of variance and q test,and the correlation was tested by linear regression analysis.MAIN OUTCOME MEASURES:①Comparison of blood glucose and serum fructosamine among the groups;②Correlation between serum fructosamine and blood glucose in patients with diabetes mellitus secondary cerebrovascular diseases and those without diabetes mellitus.RESULTS:All the 48 patients with cerebrovascular disease and 50 healthy subjects were involved in the analysis of results.①Contents of blood glucose and serum fructosamine:There were obvious differences in the contents of blood glucose and serum fructosamine among the diabetes mellitus group,without diabetes mellitus group and control group(F=577.7,115.1,P<0.01).The content of serum fructosamine in the diabetes mellitus group[(4.25±1.35)mmol/L]was obviously higher than those in the control group and without diabetes mellitus group[(1.65±0.27),(1.96±0.25)mmol/L,q=1.47,1.30,P<0.01],whereas there was no significant difference between the without diabetes mellitus group and control group(P>0.05).The content of blood glucose was obviously higher in the patients with and without diabetes mellitus groups[(15.80±2.13),(9.50±1.78)mmol/L]than in the control group[(4.56±0.77)mmol/L,q=1.86,2.46,P<0.01],also markedly higher in the with diabetes mellitus group than in the without diabetes mellitus group(q=1.42,P<0.01).②Results of correlation analysis:The content of serum fructosamine was positively correlated with the level of fasting blood glucose in the patients with diabetes mellitus secondary cerebrovascular diseases(r=0.603,P<0.01).But there was no relationship between serum fructosamine and fasting blood glucose in the patients without diabetes mellitus(r=0.357,P>0.05).CONCLUSION:The contents of blood glucose and serum fructosamine were obviously different among the diabetes mellitus group,without diabetes mellitus group and control group.There are closer relations between serum fructosamine and blood glucose in patients with diabetes mellitus secondary cerebral disorders,which are not observed in the patients without diabetes mellitus.Fructosamine is significant in differentiating the reasons for the increased blood glucose in patients with acute cerebrovascular disease.

Correlation between women's sub-health and reproductive diseases with pregnancies and labors

OBJECTIVE: To investigate whether female sub-health conditions and reproductive diseases areassociated with pregnancies and labors.METHODS: A cross-sectional survey was performed by using a structured questionnaire. A total of 1343 women aged 35 years or younger in six urban areas of Chengdu were included in the study.According to the Screening Criteria of sub-health conditions, these women were categorized into three groups: postpartum healthy group,sub-healthy group, and reproductive disease group. Data were double-entered using EpiData and the nanalyzed by SPSS.RESULTS: Pregnancy and labor were correlated with postpartum sub-health conditions. The number of pregnancies was negatively correlated with women's postnatal health but was positively correlated with the incidence of postpartum reproductive diseases.CONCLUSION: The number of pregnancies and labors is probably an important factor leading to sub-health conditions and the occurrence of reproductive diseases in women. Avoiding or reducing unwanted pregnancies and labors, enhancing the awareness of health among child bearing-age women are effective measures for preventing sub-health conditions.