RESUMEN
(1)H, (13)C and (31)P magic angle spinning magnetic resonance spectra (MAS NMR) of lyophilized brain tissue specimens were recorded. Among the 35 cases of brain tumors there were 24 glioblastomas, seven meningiomas and a few other types. (1)H NMR measurements were performed with a MAS speed of 33 kHz. The intense CH(3), CH(2) and CH peaks in the (1)H spectrum result from fatty acid residues of phospholipids, which are "mobile enough" besides the anhydrous environment. (13)C CPMAS spectra revealed the resonances of creatine and guanidine carbons; the high intensity signals arise from carbonyl groups and methylene carbons of lipids. In particular we found a fraction of mobile lipids, characterized by narrow resonances and long T(1rho)(H) Overlapped resonances of phospholipids head groups contributed to the peak at 4-7 ppm in the (31)P MAS NMR spectra. Our results indicate that (1)H and (13)C MAS NMR are able to characterize tumor types: differentiate glioblastomas from meningiomas and shed light on tumor biochemical characteristics. However, water soluble metabolites are not observed and macromolecules yield broad overlapped resonances. Generally, lyophilization significantly decreases discriminative potential of NMR analysis.
Asunto(s)
Neoplasias Encefálicas/química , Neoplasias Encefálicas/patología , Espectroscopía de Resonancia Magnética/métodos , Neoplasias Encefálicas/metabolismo , Neoplasias Encefálicas/cirugía , Liofilización , Humanos , Solubilidad , Factores de TiempoRESUMEN
Biopsies of 6 malignant gliomas (grade 3 or 4) and 11 low-grade meningiomas were extracted with perchloric acid or methanol/water, and the fully-relaxed 1H-MRS spectra of the extracts containing water-soluble metabolites and a concentration and chemical shift standard were recorded at 11.4 T. The resonance signals assigned to inositol (Ino), glycerophospho- and phosphocholine (GPC + PC), choline (Cho), creatine and phosphocreatine (Cr + PCr), glutamate (Glu), acetate (Ac), alanine (Ala) and lactate (Lac) were integrated, and analyzed by two methods. First, the concentrations of the aforementioned substances in the bioptates were estimated from their resonance signals in the extracts. Second, these signals were normalized to the Cr + PCr resonance signal. The Mann-Whitney U-test was used to verify statistical significance between the data sets obtained for gliomas and meningiomas. When the first method of analysis was used, the only difference was in the Ala concentration, which in meningiomas was on average 4 times higher than in gliomas (P < 0.01). However, when the second method of analysis was applied, gliomas expressed lower normalized resonance signals of Ala and Glu (P < 0.001, ranges not overlapping), Lac (P < 0.005), as well as Ino and GPC + PC (P < 0.05). In proton MR spectra of brain tumor tissue extracts containing water soluble metabolites, the resonance signals normalized to that of total creatine may provide a very good discrimination between malignant gliomas and low-grade meningiomas.
Asunto(s)
Neoplasias Encefálicas/diagnóstico , Metabolismo Energético/fisiología , Glioma/diagnóstico , Espectroscopía de Resonancia Magnética , Neoplasias Meníngeas/diagnóstico , Meningioma/diagnóstico , Biopsia , Encéfalo/patología , Encéfalo/fisiopatología , Neoplasias Encefálicas/patología , Neoplasias Encefálicas/cirugía , Creatina/metabolismo , Diagnóstico Diferencial , Glioma/patología , Glioma/cirugía , Humanos , Neoplasias Meníngeas/patología , Neoplasias Meníngeas/cirugía , Meninges/patología , Meninges/fisiopatología , Meningioma/patología , Meningioma/cirugía , Fosfocreatina/metabolismo , Valor Predictivo de las Pruebas , Pronóstico , Valores de ReferenciaRESUMEN
The authors present the value of frequency spectrum analysis in the method of cerebral mapping for the diagnosis and localization of epileptic focus. The patient aged 17 years showed atypical clinical symptoms. The study made possible confirmation of epilepsy, demonstration of two independent epileptogenic foci, and correlation of the atypical clinical syndrome with the location of the foci. The results are presented on topographic maps of the brain.
Asunto(s)
Mapeo Encefálico , Encéfalo/fisiopatología , Epilepsia/fisiopatología , Adolescente , Electroencefalografía , Epilepsia/diagnóstico , Humanos , Imagen por Resonancia Magnética , MasculinoRESUMEN
Spinal potentials were evoked stimulating the peripheral nerves of lower extremities in healthy people and in patients with manifestations of lumbar disc prolapse. The patients were studied before and early after the operation. In healthy subjects the velocity of impulse conduction was nearly identical when both extremities were compared. In the patients the test before the operation revealed a significant prolongation of the latency of the potentials on the side of the damaged nerve root. After the operation a significant difference between the healthy and the affected side was still present early after the operation but it was significantly smaller than before the operation since the conduction velocity was improved on the side of the operation. The study of spinal evoked potentials makes possible recognition of disturbed function of nerve roots, and after the operation the rate of changes of potential latency is an important prognostic sign.
Asunto(s)
Potenciales Evocados Somatosensoriales/fisiología , Desplazamiento del Disco Intervertebral/fisiopatología , Vértebras Lumbares/inervación , Médula Espinal/fisiopatología , Adulto , Femenino , Humanos , Desplazamiento del Disco Intervertebral/cirugía , Pierna/inervación , Vértebras Lumbares/cirugía , Masculino , Conducción Nerviosa/fisiología , Periodo Posoperatorio , Cuidados Preoperatorios , Pronóstico , Nervio Tibial/fisiopatologíaRESUMEN
The paper presents the results of the analysis of atonic epileptic seizures with application of brain mapping eeg. The views to date on the pathogenesis of atonic seizures could be based on the assumptions of centrencephalic epilepsy voiced by Penfield and Jasper. The present investigations and electrophysiological-clinical observations support, however, contrary to the concept of Penfield and Jasper, the cortical origin of these seizures. The discussion on the clinical forms of atonic seizures in epilepsy, confirmed by analysis of brain mapping in the domain of frequencies and amplitude distribution, in the form of brain topograms, allows for the concept of cortical origin of these seizures with the probability of localisation of the epileptic focus, as in here presented case, in the anterior right paramedial frontal region of the brain.