Resection of parietal lobe gliomas： incidence and evolution of neurological deficits in 28 consecutive patients correlated to the location and morphological characteristics of the tumor

OBJECT： The goal of this study is to report the incidence and clinical evolution of neurological deficits in patients who underwent resection of gliomas confined to the parietal lobe. METHODS： Patient demographics, findings of serial neurological examinations, tumor location and neuroimaging characteristics, extent of resection, and surgical outcomes were tabulated by reviewing inpatient and office records, as well as all pre- and postoperative magnetic resonance （MR） images obtained in 28 consecutive patients who underwent resection of a glial neoplasm found on imaging studies to be confined to the parietal lobe. Neurological deficits were correlated with hemispheric dominance, location of the lesion within the superior or inferior parietal lobules, subcortical extension, and involvement of the postcentral gyms. The tumors were located in the dominant hemisphere in 18 patients （64%）; had a mean diameter of 39 mm （range 14-69 mm）; were isolated to the superior parietal lobule in six patients （21%） and to the inferior parietal lobule in eight patients （29%）; and involved both lobules in 14 patients （50%）. Gross-total resection, documented by MR imaging, was achieved in 24 patients （86%）. Postoperatively, nine patients （32%） experienced new neurological deficits, whereas seven （25%） had an improvement in their preoperative deficit. A correlation was noted between larger tumors and the presence of neurological deficits both before and after resection. Postoperatively higher-level （association） parietal deficits were noted only in patients with tumors involving both the superior and inferior parietal lobules in the dominant hemisphere. At the 3-month follow-up examination, five of nine new postoperative deficits had resolved. CONCLUSIONS： Neurological deterioration and improvement occur after resection of parietal lobe gliomas. Parietal lobe association deficits, specifically the components of Gerstmann syndrome, are mostly associated with large tumors that involve both the superior and inferior parietal lobules of the dominant hemisphere. New hemineglect or sensory extinction was not noted in any patient following resection of lesions located in the nondominant hemisphere. Nevertheless, primary parietal lobe deficits （for example, a visual field loss or cortical sensory syndrome） occurred in patients regardless of hemispheric dominance.     

关于全科医生若干问题的答复

本对医学院校学生就全科医生有关问题给于相应的答复，其中还包括自１９９７年以来由美国全科医学会举办的学生代表大会上所提出的一些问题，例如：什么是全科医生？全科医生的行业范围是什么？全科医生的工作，生活及收入情况如何等等问题。（Ａｍ．Ｆａｍ．Ｐｈｙｓｉｃｉａｎ１９９０．６０：１６７－１７４）。     

Susceptibilities of Oral Microbes to Some Medicinal Herbs

目的：检测某些中草药对口腔微生物的抑制杀灭作用。方法：制备七种中草药液提取物,将水浸液提取物分别加至培养基中,观察各种口腔微生物的生长速度,确定水浸 液提取物的最小抑菌量。结果：夏枯草、金银花、厚朴、菊花、威灵仙、秦艽的水浸液提取物对所试验的口腔微生物生长无明显抑制作用,而黄连的水浸液提取物有明显的抑制作用。尤其对牙周致病菌牙龈卟啉菌（初始抑菌量０．２５０ｍｇ／ｍｌ）、伴放线放线杆菌（初始抑菌量０