Comparison of the intracarotid amobarbital procedure and interictal cerebral 18-fluorodeoxyglucose positron emission tomography scans in refractory temporal lobe epilepsy.

The relationship between interictal focal hypometabolism determined by 18-fluorodeoxyglucose positron emission tomography (FDG-PET) scans and memory function with the intracarotid amobarbital procedure (IAP) was evaluated in 23 patients with temporal lobe epilepsy. All patients underwent prolonged EEG/video monitoring. The epileptogenic focus was defined by interictal epileptiform discharges and ictal onsets. All 23 patients had recorded seizures arising exclusively from one temporal lobe. PET showed temporal lobe hypometabolism ipsilateral to the epileptogenic focus in 86% (20 of 23) of patients; IAP showed impaired memory of the hemisphere of seizure onset in 65% (15 of 23). Sixty-five percent (13 of 20) of patients with focal hypometabolism had ipsilateral memory impairment. Memory impairment contralateral to the hypometabolic zone was not observed. Ninety-five percent (22 of 23) of patients demonstrated functional impairment by either PET or IAP (or both) on the epileptogenic side.     

柱前荧光标记高效液相色谱法对血浆中l-麻黄碱和d-伪麻黄碱的定量分析

l-麻黄碱和d-伪麻黄碱是生药麻黄中早为人知而至今仍被广泛用于临床的一对手性异构生物碱。由于二者为生药麻黄中的主要成分但药理活性不同,为便于临床监控及有效用药,高分辨高灵敏度的检测方法的开发迫在眉睫。本文以易于得到的dansylchloride为柱前荧光标识试剂,在确定了最佳衍生化及分离条件的基础上,建立了理想的色谱分析系统(线性检测范围1～800ng·ml^-1)。同时运用此方法,完成了对静注l-麻黄碱和d-伪麻黄碱后豚鼠血浆内该对手性异构体水平的考查,并且定量检测了服用中成药小青龙合剂后人血浆中的该对手性异构体。     

Pachygyriclike changes: topographic appearance at MR imaging and CT and correlation with neurologic status

Studies of 23 pediatric patients with pachygyriclike changes (PLCs) examined with computed tomography (CT) and magnetic resonance (MR) imaging were reviewed to determine topographic patterns and correlate them with various clinical syndromes and degrees of neurologic impairment. Three types of topographic distributions were identified: unilateral, diffuse, and bilateral nondiffuse (of which eight of 10 showed frontotemporal predominance). PLCs were an isolated finding in seven patients, were associated with various congenital syndromes in nine patients, and were associated with congenital infection in seven patients, six of whom showed marked white matter abnormalities. Although most patients had severe developmental delay, three with nondiffuse PLCs had less severe impairment, permitting less required care.     

Ipsilateral trigeminal sensory responses to cortical stimulation by subdural electrodes

Twelve patients with medically intractable epilepsy had plates of chronic subdural electrodes placed over the lateral and basal cortical hemispheres during evaluations for surgical therapy. During cortical stimulation, ipsilateral sensations involving any of the branches of the trigeminal nerve were noted in the eye, face, and mouth. Some responses could have been due to dural or direct trigeminal nerve trunk stimulation, but others were probably due to electrical stimulation of trigeminal fibers accompanying the pial-arachnoidal vessels. These fibers had been demonstrated in animals, but not in humans.     

Results of testicular autotransplantation using the microvascular technique: experience with 8 intra-abdominal testes

Children with intra-abdominal testes comprise a small group presenting for surgical management of the undescended testicle. During the last 4 years 6 children with 8 intra-abdominal testes have undergone testicular surgery. In 7 testicles the technique involved high intraperitoneal division of the testicular pedicle with reanastomosis of the distal spermatic artery and vein to the inferior epigastric artery and vein using the operating room microscope. Microsurgery on the 7 intra-abdominal testicles led to good results in 6 cases. In 1 testicle venous infarction occurred secondary to venous congestion. Although many children with intra-abdominal testes have been managed using the standard Stephens-Fowler technique, we believe that microsurgical reanastomosis will improve the previously reported results.     

Isolation of intestinal spirochaetes from homosexuals

Spirochaetes were isolated from rectal swabs of two homosexuals and the faeces of a third, using simple isolation techniques not previously applied to specimens of this type. The ease of culture of these organisms will enable their distribution and pathogenicity to be studied, particularly in relation to their significance in homosexuals.