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Malignant gliomas are a common type of primary tumor of the central nervous system. In spite of current intensive therapy, the prognosis of patients with malignant glioma remains poor, hence the development of novel therapeutic modalities is necessary. Cell apoptosis is a frequent target in the development of anti‑cancer drugs. Fatsioside A, a novel baccharane‑type triterpenoid glycoside, is extracted from the fruits of Fatsia japonica. Previous studies have shown that Fatsioside A induces growth inhibition, cell cycle arrest and apoptosis in C6 rat glioma cells and U251 human glioma cells. However, to the best of our knowledge, no detailed studies have reported its effect on U87MG glioma cells and its exact mechanisms remain unknown. In the current study, the growth inhibitory effect of Fatsioside A on U87MG cells was evaluated and the underlying molecular mechanisms were explored. Through the use of flow cytometry and a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay, it was determined that Fatsioside A markedly inhibits the growth of U87MG cells. Mechanistic studies demonstrated that Fatsioside A induces growth inhibition of U87MG cells via the induction of endoplasmic reticulum (ER) stress, which was supported by the upregulation of ER stress markers, including elevated levels of phosphorylation of PERK and eIF2α, the increased expression levels of CHOP and the accelerated cleavage of caspase‑4. The downregulation of CHOP via CHOP‑specific siRNA reduced the growth‑inhibitive effect of Fatsioside A on U87MG cells, further confirming the role of the ER stress response in mediating Fatsioside A‑induced growth inhibition. In conclusion, Fatsioside A inhibits glioma cell growth via the induction of ER stress‑mediated apoptosis. This may provide a molecular basis for the development of Fatsioside A into a drug candidate for the treatment of malignant glioma.

Pial arteriovenous fistula (AVF) is an extremely rare intracranial vascular lesion. The pediatric type of AVF has a high percentage of varix, leading to mass effect with symptoms. We report a 12-year-old boy who was admitted due to sudden confusion and urinary incontinence. Computed tomography, magnetic resonance imaging, and magnetic resonance angiography (MRA) confirmed the diagnosis of congenital pial AVF. Digital subtraction angiography (DSA) revealed the lesion originating from the left middle cerebral artery and draining into the superior sagittal sinus. The AVF was successfully obliterated with six microcoils and 2.5-mL ethylene vinyl alcohol copolymer using a middle cerebral artery approach. This patient was discharged without neurologic deficits. The AVF became smaller and ultimately disappeared on the DSA and MRA at follow-up.

Background Evaluation of fetal central nervous system (CNS) agenesis by ultrasonography (US) is frequently limited, but magnetic resonance imaging (MRI) has its own advantages and is gaining popularity in displaying suspected fetal anomalies. The purpose of this study was to explore the value of MRI in detecting fetal CNS agenesis. Methods Thirty-four women (aged from 22 to 35 years, average 27 years) with complicated pregnancies (16- 39 weeks of gestation, average 30 weeks) were examined with a 1.5 T superconductive MR unit within 24 hours after ultrasonography. Half-Fourier acquisition single-shot turbo spin-echo (HASTE) T2-weighted imaging (T2WI) sequence were performed in all patients, and fast low angle shot (FLASH) T1-weighted imaging (T1WI) sequence were applied sequentially in seven of them. Comparison of the results was made between the MRI and US findings as well as autopsy or postnatal follow-up MRI findings. Results The gyrus, sulcus, corpus callosum, thalamus, cerebellum, brainstem, and spinal cord of fetus were shown more clearly on T2-weighted MR images than on T1weighted MR images. MRI corrected the diagnosis of US in 10 cases (10/34, 29.41%) and the diagnosis was missed only in 1 case (1/34, 2.94%). Conclusion MRI has advantages to US in detecting fetal CNS anomalies and is a supplement to US in complicated pregnancies. Chin Med J 2006; 119(15): 1272-1277

Objective The aim of this study was to determine differences in diameter of cochlear nerves (CN) among three measurement points at the midpoint of the internal auditory canal (IAC), IAC fundus and cochlear aperture, and to evaluate whether nerve size varies with age. Methods A total of 336 normal-hearing ears of 201 children were assessed, who were underwent 3D-Fiesta sequence scanning of inner ear. All subjects were divided into 12 groups at one year interval. The diameter measurements of CN were obtained in the midpoint of the IAC, IAC fundus and cochlear aperture respectively on the axial and oblique sagittal images of 3.0-T MRI. SPSS 18.0 statistics software was applied for data analysis, and all of the data showed a normal distribution and expressed in x ¯ ± s . Results The diameters of normal-hearing children's CN at the midpoint of the IAC, IAC fundus and cochlear aperture were respectively: 1.12 ± 0.08 mm, 1.05 ± 0.06 mm, 0.87 ± 0.14 mm, and there were significant differences among the three measuring points ( F = 527.57, p p > 0.05) in age groups, gender and sides ( p > 0.05), and there was no correlation between the diameters of normal children's CN and age ( r is −0.129, 0.128 and −0.113, respectively). Conclusion The diameters of normal-hearing children's CN change with different points of the internal auditory canal, of which the maximum value is in the midpoint of the IAC, followed by the IAC fundus, and the cochlear aperture is at the minimum; moreover the normal size doesn’t change with age.

To study the feasibility of endolymphatic visualization and the diagnosis of Meniere's disease by applying intratympanic gadolinium administration through the tympanic membrance and three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging (3D-FLAIR MRI). To study the relationship between the endolymphatic hydrops visualized by MRI and audio-vestibular functional tests, such as pure tone audiometry (PTA), electrocochleography (EcoG), caloric test and vestibular evoked myogenic potential (VEMP).With a three Tesla magnetic resonance imaging (MRI) unit, 3D-FLAIR imaging was performed 24 hours after intratympanic gadolinium through the tympanic membrance in 32 patients with clinically diagnosed unilateral Meniere's Disease. We visualized the enhanced imaging of perilymphatic space in bilateral cochlea, vestibular and (or) canal, scoring scala tympani and scala vestibule of bilateral cochlear basal turn respectively and measuring the developing area of bilateral vestibule and the signal intensity ratio (SIR) between the vestibule and the brain stem subjectively. PTA, EcoG, caloric test and VEMP were performed. The relationship between the endolymphatic hydrops visualized by MRI and audio-vestibular functional tests were studied.The gadolinium appeared in almost all parts of the perilymph in cochlea, vestibular and (or) canals in all 32 patients' inner ears, so the endolymphatic space was clearly shown on 3D-FLAIR imaging. The scala vestibuli score value between the affected side and the healthy side were statistically significant (Z = 4.309, P0.05) . The developing vestibular area between the affected side and the healthy side [(6.04 ± 2.89) mm(2), (8.28 ± 3.04)mm(2)] were statistically significant (t = 3.322, P0.05) . Abnormal vestibular evoked myogenic potentials were significantly correlated with the developing vestibular area of the affected side (F = 11.96, P0.05) . Abnormal electrocochleography were significantly correlated with scala vestibuli score value of cochlear basal turn in the affected side (Z = 3.17, P0.05) . No significant correlation was found between the scala vestibuli score value or the developing vestibular area and caloric test or PTA findings.3D-FLAIR MRI with intratympanic gadolinium injection through the tympanic membrance can discriminate the border between the perilymph and the endolymph and show endolymphatic hydrops. This method may provide radiographic reference for the diagnosis of Meniere's disease. The results of VEMP and electrocochleography might have appropriate correlation with degree of vestibular and cochlear hydrops.

HIV is a neurotropic virus which can cause brain white matter demyelination, gliosis, and other pathological changes that appear as HIV encephalitis or AIDS dementia. The purpose of this study was to investigate the change of the diffused condition of water molecules in brain white matter in early acquired immune deficiency syndrome (AIDS) patients using MR diffusion tensor imaging (DTI).DTI examinations were performed on a Siemens 3.0T MR scanner in 23 AIDS patients with normal brain appearance by conventional MRI and 20 healthy volunteers as the control group. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were measured in nine regions; corpus callosum (CC) knee, CC body, CC splenium, periventricular white matter, frontal lobe white matter, parietal lobe white matter, occipital lobe white matter, and the anterior and posterior limbs of the internal capsule. The mean FA and ADC values from each region were compared in three groups: the symptomatic, asymptomatic and the control.The mean FA values were significantly lower and the mean ADC values were significantly higher in all nine regions in patients in the symptomatic group than in the asymptomatic and control group patients. In the asymptomatic group, the mean FA values were significantly lower and the mean ADC values were significantly higher at the CC knee, CC body, CC splenium, periventricular white matter, frontal lobe white matter and parietal lobe white matter, than in the control group. There were no significant differences at other regions between the two groups.The diffused changes of water molecules in brain white matter in AIDS patients are related to brain white matter regions. DTI examination can detect the brain white matter lesions early in AIDS patients.

To evaluate the preoperative pain degree of lumbar intervertebral disc herniation and analyzed its reason.From January 2002 to December 2008,265 patients with lumbar intervertebral disc herniation were operated by single segment, of which site in L4,5 was 128 cases and in L5S1 was 137 cases. There were 162 males and 103 female, ranging in age from 21 to 78 years, with an average of 46.3 years. Oswestry index of all patients was observed before operation. The patients were divided into five groups based on Carragee system (according to degree of nucleus pulposus herniation and degree of fibrous ring cleavage to group, prolapse and liberation of nucleus pulposus with small ring cleavage was group I; prolapse and liberation with large ring cleavage was group II; contained fragment with integrated fibrous ring was group III; no contained fragment with integrated fibrous ring was group IV; calcified nucleus pulposus with degenerative fibrous ring was group V). The associativity between five types of lumbar intervertebral disc herniation and preoperative pain degree was analyzed.The preoperative pain in group I and group II was more severe than that of other groups (P0.01). The preoperative pain in group II was more severe than that of group I (P0.01).Nucleus pulposus can migrated into the spinal canal and will aggravate the nerve root pain if lumbar intervertebral disc herniation accompanies with fibrous ring cleavage; and freed materials can aggravate the nerve root pain by the chemical factor.

To compare the value of ultrasound and magnetic resonance imaging (MRI) in detecting fetal spine and spinal cord dysplasia.Thirty women with complicated pregnancies, age from 22 to 41 years, gestation from 23-38 weeks, were studied with MRI within 72 hours after ultrasound studies and revealed 19 cases of fetal spine with irregular, 7 cases of vertebral canal widened partly and 4 cases of anomalies of spinal curvature. Autopsy or imaging was conducted when pregnancy was terminated. A close follow-up was given for cases continuing pregnancy within 12 months after delivery.(1) Nineteen cases of fetal spine with irregular in ultrasound, the coincidence of antenatal sonographic diagnosis was 42% (8/19), the coincidence of antenatal MRI diagnosis was 89% (17/19). Seven cases of vertebral canal widened partly in ultrasound, the coincidence of antenatal sonographic diagnosis was 0, the coincidence of antenatal MRI diagnosis was 7/7. Four cases of anomalies of spinal curvature in ultrasound, the coincidence of antenatal sonographic diagnosis was 2/4, the coincidence of antenatal MRI diagnosis was 3/4.(2) By MRI study, one cases were conformed their ultrasound diagnosis, eleven cases were completed their ultrasound diagnosis, nine cases were made the same diagnosis as ultrasound and six cases were corrected diagnosis. By MRI and ultrasound study one case of hemivertebra, one case of butterfly vertebra and one case of dorsal dermal sinus were missed diagnosis. Ultrasound had limits and low specificity especially in fetal spinal cord.MRI can show the spinal cord and its lesion intuitively and has advantages in displaying fetal anomaly of spine and spinal cord. MRI is a valuable complement to sonography in difficult cases and diagnostic accuracy can be significantly improved.

To analyze effect of treatment of lumbar intervertebral disc herniation with nucleus pulposus resection through small incision and lamina fenestration,and to explore operative advantage and mattars needing attention.Ninety-six patients with lumbar intervertebral disc herniation, including 48 males and 48 females with an average age of 46.4 years (ranging for 16-75 years) and an average course of 5 years (ranging from 1 month to 30 years), were treated with nucleus pulposus resection through small incision and lamina fenestration. The clinical effects were analyzed according to JOA scoring criteria of lower back pain.All patients were followed up from 6 months to 3.5 years with an average of 1.2 years. According to JOA scoring criteria, 34 cases obtained excellent result, 55 good, fair 7. The rate of excellent and good was 92.71% and the mean improvement rate was 54.53%.Nucleus pulposus resection through small incision and lamina fenestration can obtain satisfactory outcome in treating lumbar intertebral disc herniation. The incidence of lumbar instability and postoperative complications were low. It is one of the better method for the treatment of lumbar intertebral disc herniation.

To explore the functional brain localization with magnetic resonance imaging (MRI) after acupuncturing the Yuan-Source and He-Sea acupoints of Stomach Meridian of Foot-Yangming (ST).The study was performed in 30 healthy volunteers who underwent acupuncture at Yuan-Source acupoint (Chongyang, ST42) and He-Sea acupoint (Zusanli, ST36) (ST group). Ten of these were also underwent acupuncture at the non-acupoints as the control group. Blood oxygenation level dependent functional MRI was performed.In the ST group, signal increasing areas were demonstrated in bilateral superior temporal gyri (Broadmann 22), bilateral supramarginal gyri (Broadmann 40), bilateral cerebellar hemispheres, bilateral cingulate gyri and isthmus of cingulate gyri (Broadmann 32, 30), bilateral superior parietal lobules (Broadmann 7); signal decreasing areas were shown in bilateral orbital gyri (Broadmann 11), bilateral temporal pole (Broadmann 38), right inferior frontal gyrus (Broadmann 47) and right medial occipitotemporal gyrus (Broadmann 36). In the control group, signal increases areas were demonstrated in superior temporal gyri, precentral gyri, cingulate gyri, thalamus, insula and cerebellum. The size, signal intensity and number of increasing areas in control group are less than in ST group.Combined acupuncture of Yuan-Source and He-Sea acupoints of ST can activate and decrease the multiple brain regions of "splanchnic brain" and thus reach a new functional balance to relieve pain.