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81.
T. Hammen F. Kerling M. Schwarz A. Stadlbauer O. Ganslandt B. Keck B. Tomandl A. Dörfler H. Stefan 《European journal of neurology》2006,13(5):482-490
Up to 30% of patients with temporal lobe epilepsy (TLE) remain without remarkable changes in MRI. In this study we investigated the role of (1)H-MR spectroscopy ((1)H-MRS) in lateralizing the affected hemisphere in the mentioned patient group. Twenty-two consecutive patients diagnosed with TLE were investigated by high resolution MRI and (1)H-MRS. We examined the incidence and diagnostic accuracy of temporal metabolite alterations determined by Linear Combination of Model Spectra (L C Model) via water reference. Metabolite values of each hemisphere of TLE patients were compared with healthy controls. Results of metabolite alterations were related to intensive video EEG focus localization. Reduction of N-acetylaspartate + N-acetylaspartyl-glutamate (tNAA) in the affected hemisphere revealed identification in six of nine patients (66%) with unilateral TLE. Group comparison revealed a significant reduction of tNAA (6.1+/-0.8*) in the involved temporal lobe compared with controls (6.67+/-0.4*, P=0.026). Choline levels were significantly increased in the affected hemisphere (1.42+/-0.17*) compared with healthy controls (1.22+/-0.17*, P=0.035). The results of our study show that (1)H-MRS is able to identify the affected hemisphere of MRI negative TLE patients and can be used as an additive tool in multimodal focus localization. 相似文献
82.
麻醉深度监测技术及其临床应用 总被引:1,自引:0,他引:1
麻醉深度监测对提高麻醉质量,保障病人的围术期安全与康复具有极为重要的意义,适当的麻醉深度是保证病人生命安全、创造良好手术条件的关键因素之一。术中监测麻醉深度能提高麻醉质量和手术安全性,减少麻醉并发症。现对临床常用的麻醉深度监测技术及其临床应用情况作一综述。 相似文献
83.
A. C. T. Huizinga R. H. G. Vandenbrom J. M. K. H. Wierda M.D. Ph.D. F. D. M. Hommes P. J. Hennis 《Acta anaesthesiologica Scandinavica》1992,36(5):463-468
The intubating conditions and neuromuscular blocking profile following 600 micrograms.kg-1 rocuronium (Org 9426) have been investigated in patients under various experimental conditions. They were compared with conditions following 1.5 mg.kg-1 suxamethonium, preceded by a precurarising dose (10 mg) of gallamine, and with those in a control group in the absence of a muscle relaxant. Rocuronium produced good to excellent intubating conditions at 60 as well as at 90 s after administration, even though there was only a partial blockade of the adductor pollicis muscle. Intubating conditions following suxamethonium were comparable with those after rocuronium. Half of the control patients could be intubated. The clinical duration and the recovery time of 600 micrograms.kg-1 of rocuronium were 24(4) and 9(3) min (mean(s.d.)), respectively. Rocuronium may have a major advantage over existing non-depolarising muscle relaxants due to the early presence of excellent intubating conditions. The results indicate that rocuronium may replace suxamethonium in procedures in which rapid sequence induction is required. 相似文献
84.
Five-Year Outcome After Epilepsy Surgery in Nonmonitored and Monitored Surgical Candidates 总被引:9,自引:9,他引:0
Mark D. Holmes† Carl B. Dodrill†‡ Linda M. Ojemann †‡ George A. Ojemann†‡ 《Epilepsia》1996,37(8):748-752
Summary: Purpose : We wished to compare outcome 5 years after temporal lobectomy in 28 patients selected for surgery on the basis of interictal EEG patterns with that in 46 patients who underwent EEG-video monitoring studies as part of their preoperative evaluation during the same era.
Methods : The 28 nonmonitored patients had interictal EEG patterns that demonstrated a consistent, unilateral, anterior-midtemporal epileptiform focus, without discordant findings from other studies. Outcomes were assessed for years 4 and 5 after operation.
Results : Twenty-six of 28 (92.9%) nonmonitored patients were seizure-free or had at least 75% reduction in seizures. Twenty-nine of 46 (63.0%) monitored patients were seizure-free or had at least 75% reduction in seizures. Preoperative interictal EEGs of 29 of these patients showed independently localized bitemporal, ex-tratemporal, midposterior temporal, or diffuse epileptiform patterns. The remaining 17 monitored patients had preoperative strictly unilateral anterior-midtemporal interictal discharges, and their outcome was comparable to the nonmonitored group, with 15 (88.8%) seizure-free or with at least 75% reduction in seizures.
Conclusions : A proportion of candidates for epilepsy surgery can be selected without ictal recordings provided that interictal EEGs demonstrate consistent unilateral anterior-midtemporal epileptiform discharges and that other data are not discordant. 相似文献
Methods : The 28 nonmonitored patients had interictal EEG patterns that demonstrated a consistent, unilateral, anterior-midtemporal epileptiform focus, without discordant findings from other studies. Outcomes were assessed for years 4 and 5 after operation.
Results : Twenty-six of 28 (92.9%) nonmonitored patients were seizure-free or had at least 75% reduction in seizures. Twenty-nine of 46 (63.0%) monitored patients were seizure-free or had at least 75% reduction in seizures. Preoperative interictal EEGs of 29 of these patients showed independently localized bitemporal, ex-tratemporal, midposterior temporal, or diffuse epileptiform patterns. The remaining 17 monitored patients had preoperative strictly unilateral anterior-midtemporal interictal discharges, and their outcome was comparable to the nonmonitored group, with 15 (88.8%) seizure-free or with at least 75% reduction in seizures.
Conclusions : A proportion of candidates for epilepsy surgery can be selected without ictal recordings provided that interictal EEGs demonstrate consistent unilateral anterior-midtemporal epileptiform discharges and that other data are not discordant. 相似文献
85.
Stuart A. Batterman Alfred Franzblau Nanzheng Zhou 《International archives of occupational and environmental health》1996,68(4):268-274
Dermal exposures of methanol were administered in a clinical study designed to compare several biological indicators. Four
subjects were exposed in five exposure sessions of varying length. In each session, a sequence of measurements of methanol
concentrations in blood, breath, and headspace samples of air at exposed and unexposed skin were collected before and after
dermal exposures. Skin headspace samples, collected in gas sampling bags, were designed to reflect equilibrium skin: air partitioning.
At exposed skin, headspace samples were highly elevated for at least 8 h following exposure, indicating the presence of a
methanol reservoir in skin. After exposure, methanol concentrations at exposed skin showed a rapid initial decline, then a
slower first-order decrease. Methanol concentrations were clearly detectable in headspace samples at unexposed skin. Substantial
transfer from exposed skin occurred due to mechanical contact and washing. When transfer was restricted, surface concentrations
at unexposed skin were similar to levels in breath and were strongly correlated to methanol concentrations in blood. While
results are preliminary due to the small sample sizes and several unresolved experimental issues, the simple, rapid, and noninvasive
skin headspace measurements appear useful as a biological exposure indicator that clearly shows the presence and site of a
dermal exposure, and measurements at unexposed skin reflect concentrations in blood.
Received: 14 March 1995/Accepted: 3 November 1995 相似文献
86.
87.
Little is known about whether patients with photosensitive disorders exhibit a different ultraviolet erythema time course from subjects with a normal response to sunlight. We have described the application of an instrument for ambulatory monitoring of the development of ultraviolet erythema by a reflectance method in a group of patients with chronic actinic dermatitis (CAD) and in a group of normal subjects. Investigations of the time course have been reported previously but the techniques used relied upon manual measurement. Consequently sampling frequencies have been considerably lower than the one-minute sample rate used here. We have not demonstrated any difference in the rate at which erythema develops and peaks between patients with CAD and subjects with a normal response to sunlight. 相似文献
88.
Hans-Günter Neumann 《International archives of occupational and environmental health》1988,60(3):151-155
Summary Analysis of hemoglobin adducts in blood samples is suitable for the biological monitoring of genotoxic chemicals. The method is specific because the compound to which the individual was exposed is identified. The sensitivity of the method depends on the analytical procedure applied, but is hardly limiting since large amounts of the protein can be obtained. The method provides not only information about the internal exposure to the environmental chemical, but also about the individual's capacity to generate ultimate genotoxic metabolites from it. Since macromolecular damage in blood cells is correlated to that in potential target tissues, this information is relevant to risk assessment, insofar as macromolecular damage produced by a specific chemical can be correlated with the development of tumors. 相似文献
89.
Allen D. Roses Margaret A. Pericak-Vance Ann M. Saunders Donald Schmechel Dmitry Goldgaber Warren Strittmatter 《Epilepsia》1994,35(S1):S20-S28
Summary: Strategies used in molecular genetics have changed modern neurology. The gene or genes responsible for several major neurologic diseases have now been identified using "reverse" or positional genetics. Unexpected new genetic mechanisms have been discovered in human neurologic diseases, including (a) identical mutations of the prion protein gene in Creutzfeldt-Jakob disease and fatal familial insomnia with the phenotypic expression directed by an accompanying polymorphism; (b) stable duplications of chromosome 17 in Charcot-Marie-Tooth disease (type 1 A) that involve many genes, only one of which appears to cause neuropathy; and (c) highly variable, dynamic mutations in myotonic dystrophy, fragile X syndrome, and Kennedy's syndrome that modulate variable expressivity in multiple tissues. There is growing recognition that neurologic diseases are often complex genetic diseases with multifactorial rather than simple modes of inheritance. For example, genetic association/linkage strategies have interacted with biochemistry and immunopathology studies to produce new insights into the disease mechanism of late-onset Alzheimer's disease. The role of apolipoprotein E in late-onset Alzheimer's disease is an example of how new analytical techniques of genetic disease can be applied to dissect multiple genes. Similar research strategies are suggested for the study of epilepsy as a complex disease. 相似文献
90.
急性心肌梗死再灌注期间的心电变化特征 总被引:1,自引:1,他引:0
目的 探讨急性心肌梗死 (AMI)再灌注期间的心电变化特征。方法 46例经急诊冠状动脉造影明确为成功再灌注的AMI,其中 2 4例接受溶栓治疗和 2 2例接受直接经皮腔内冠状动脉成形 ,于发病的 6小时内以动态心电图技术持续2 4小时监测心电图变化 ,并与 1 5例无灌注者进行对比。结果 ①再灌注发生后 ,相应导联ST段迅速下降 ,约 2小时达较低水平 ;同时 ,T波正向振幅进行性降低 ,距再灌注 0~ 2 2 (2 7± 4 5)小时呈现T波倒置并逐渐加深。②再灌注后的 1小时内 ,室性心律失常明显增加 ,6~ 8小时后显著减少。结论 AMI早期再灌注发生后呈现特征性心电变化 ,及时识别这些特征将有助于临床评估再灌注状态和危险度分层 相似文献