Use of MR imaging for quantitative evaluation of resection for temporal lobe epilepsy

The postoperative magnetic resonance imaging studies of 40 patients who underwent surgery for medically refractory temporal lobe epilepsy were reviewed. A method for quantifying the resection of four specific medial temporal lobe structures--amygdala, uncus, hippocampal formation, and parahippocampal gyrus--was used to correlate postoperative seizure control with the degree to which those structures had been resected. Satisfactory postoperative seizure control was found to be strongly dependent (P less than .01) on the performance of at least partial resection of all four medial temporal lobe structures. The total amount of tissue removed did not necessarily correlate with the clinical outcome in individual cases, however, as long as some portion of all four medial structures had been resected. Two complicating factors--the presence of posterior or bilateral independent electroencephalographic foci and a history of meningoencephalitis--each negatively influenced surgical outcome (P less than .01). In cases with a complicating factor and inadequate medial resection, the outcome was invariably poor.     

Expression of tissue-type transglutaminase correlates positively with metastatic properties of human melanoma cell lines

In this study the relationship between tissue-type transglutaminase (TGase2) activity and the propensity to metastasize was investigated in human melanoma cell lines with different metastatic behavior. TGase2 catalyzes an acyl-transfer reaction between peptide-bound glutamine residues and primary amines, including the ε-amino group of lysine residues. Northern-blot analysis demonstrated that TGase2 RNA-expression (3.7 kb) was elevated in highly metastatic cell lines (MV3 and BLM) as compared to weakly metastatic ones (I F6 and 530). Immunopre-cipitation and enzyme assays of TGase2 showed that the differential expression at the mRNA level was also reflected at the protein level. These findings reveal a positive relation between the expression of TGase2 and the metastatic properties of the human melanoma cell lines. © 1995 Wiley-Liss, Inc.     

RELATIONSHIP BETWEEN NIFEDIPINE SENSITIVITY OF AORTAE AND BLOOD PRESSURE OF STROKE-PRONE SPONTANEOUSLY HYPERTENSIVE RATS

1. We have previously described an increased sensitivity to inhibition by nifedipine of noradrenaline-induced contractures of blood vessels in hypertension. In this study we have investigated whether changes in blood pressure (BP) change the sensitivity to nifedipine and K⁺ of aortic rings from normotensive (Wistar-Kyoto rats, WKY) and stroke-prone spontaneously hypertensive rats (SHRSP). 2. SHRSP were treated with: hydralazine plus hydrochloro-thiazide; captopril plus hydrochlorothiazide; hydralazine plus guanethidine; or captopril alone. WKY rats were treated with deoxycorticosterone acetate (DOCA) and NaCl. Treatment commenced from 5 weeks of age and continued until 13–15 weeks. 3. The SHRSP treatments produced similar reductions in BP, and the BP of all the treated groups were significantly lower than the mean BP of untreated SHRSP (201.0 ± 7.7 mmHg). The mean BP of the treated WKY rats (134.2 ± 7.6 mmHg) was significantly higher than the mean BP of the untreated WKY rats (86.8 ± 7.4 mmHg). 4. An area-under-curve (AUC) analysis of the inhibitory effects of nifedipine on responses of aortae to noradrenaline showed no differences between treated and untreated SHRSP groups (overall mean 40.6 ± 1.9% and 43.4 ± 3.4% inhibition of control AUC, respectively), or between DOCA-salt treated WKY and untreated WKY groups (58.8 ± 5.9 and 64.8 ± 2.3, respectively). Noradrenaline-induced contractures of aortae from all SHRSP groups were significantly more sensitive to inhibition by nifedipine than aortae from both WKY groups. 5. The molar concentration of agonist required to evoke 50% of the maximum response (EC₅₀) values for potassium chloride (KCI) were significantly increased in the aortae of all treated SHRSP groups in comparison to those from untreated SHRSP (treated SHRSP groups, 15.53 ± 0.68 mmol/L vs untreated SHRSP group, 11.36 ± 1.10 mmol/L). The EC₅₀ values for KC1 for the aortae from the DOCA-treated WKY rats were significantly less than those from aortae of the untreated WKY (11.80 ± 0.80 and 17.08 ± 1.50 mmol/L, respectively). 6. We conclude that reduction (in SHRSP) or increase (in WKY) of the BP has no effect on the sensitivity of aortic smooth muscle to the inhibitory effects of nifedipine on responses to noradrenaline, suggesting that alterations in voltage-dependent Ca²⁺ mechanisms may be a primary phenomenon in the SHRSP. In contrast, the fact that sensitivity to KC1 changes in the treated SHRSP and WKY aortae suggests such sensitivity is secondary to the BP and thus a separate phenomenon from voltage-dependent Ca²⁺ mechanisms.     

Selective posterior cerebral artery Amytal test for evaluating memory function before surgery for temporal lobe seizure

Selective testing for memory function with Amytal (amobarbital) in the posterior cerebral artery (PCA) is a promising modification of that test in the internal carotid artery (ICA). This new technique, performed with a Tracker catheter system, was completed successfully in 17 of 20 patients being examined before planned surgery for refractory temporal lobe seizure. The PCA test overcomes three major problems with the ICA technique. First, with the PCA technique, memory testing is begun immediately after injection, when the drug has its peak effect. Second, when the speech-dominant hemisphere is being tested with the PCA test, patients do not become aphasic. Third, injection into the PCA delivers the drug more effectively to the target, the ipsilateral hippocampal formation.     

A hereditary abnormal c-fms proto-oncogene in a patient with acute lymphocytic leukaemia and congenital hypothyroidism

A patient with congenital hypothyroidism and acute lymphocytic leukaemia was found to be homozygous for a 0.4 kbp deletion in the c-fms proto-oncogene. This was established by studying DNA from the patient's leukaemic cells, from cultured skin fibroblasts of the patient and from normal white blood cells of both parents. The uncertain relevance of this finding to the condition of the patient is discussed.     

调配骨水泥经皮椎体成形术注入治疗老年骨质疏松性椎体压缩骨折的疗效及其生物相容性

目的：总结经皮椎体成形术治疗老年骨质疏松性椎体压缩骨折的临床效果,并观察骨水泥材料与宿主的生物相容性反应. 方法：①患者对象：阳江市中医医院2003-02/2005-12收治的骨质疏松症性椎体压缩性骨折患者26例（32个椎体）,在C形臂X射线机透视下,行经皮椎弓根途径椎体成形术治疗.其中65岁以下的8例患者（8椎体）在硬膜外麻醉下行体位及手法复位后再行经皮椎体成形术治疗.②骨水泥注入方法及途径：调配骨水泥为英国CORIN公司生产的低黏滞度聚甲基丙烯酸甲酯,在骨水泥中加入尹索显或欧乃派克,粉∶液∶造影剂比例为3∶2∶1.应用1 mL专用注射器（美国COOK公司产品）经穿刺针将处于黏稠阶段的骨水泥注入椎体,当骨水泥达椎体后壁即停止注射.如果单侧穿刺骨水泥分布未超过椎体中线,则同时行另一侧椎弓根穿刺.③效果评估：观察椎体高度的恢复,采用目测类比评分法评估疼痛缓解程度,并发症发生情况与材料及宿主的反应. 结果：26例均完成手术进入结果分析.①每椎体注射骨水泥3.5～8.0 mL,平均4.5 mL,24 h后即离床活动.②手法复位后行经皮椎体成形术者,椎体高度椎体高度恢复到正常的75%～90%,随访≥12个月无椎体高度丢失.③术前目测类比评分为8.1（5.6～9.5）分,术后为2.7（1.2～4.8）分.23例患者腰痛术后24 h内消失,3例陈旧性骨折患者腰痛术后部分缓解.④并发骨水泥椎旁渗漏4例4椎体,未发现特殊的材料和宿主反应;前引流静脉渗漏2例2椎体,无临床症状;穿剌针抽出脑脊液1例,改行另侧穿刺成功. 结论：①经皮椎体成术治疗老年骨质疏松性椎体压缩骨折具有微创、见效快、疗效肯定的优点.②体位及手法复位后行经皮椎体成术,能大部分恢复椎体高度,适合于年龄相对较轻,椎体楔形压缩较多的患者.③只要操作熟练,单侧椎弓根穿刺即能达到临床目的.④骨水泥材料与宿主之间呈现较好的生物相容性.     

Psychometric Properties of the Sexual Event Diary in a Sample of Dutch Women With Female Sexual Interest/Arousal Disorder

Background

Efficacy of on-demand drugs for women with hypoactive sexual desire disorder or female sexual interest/arousal disorder (FSIAD) should be assessed using a validated instrument that assesses the discrete sexual events during which the on-demand drug is taken, because this type of assessment is more proximate to an on-demand drug's efficacy compared to instruments that assess sexual function over longer periods of time.