Body part asymmetry in partial seizure

Clinically differentiating between localisation related and generalised epilepsy is important because it carries significant implications for planning diagnostic management strategy. Asymmetry of body parts such as toes, popliteal crease levels, thumbs, cubital crease levels, and forehead and facial structures, are common in patients with localisation related epilepsy syndromes. We retrospectively studied 337 patients with seizure disorders. Body part asymmetry was routinely documented. Fifty-six were excluded because of non-epileptic seizures, pure psychiatric disorders, non-epileptic neurological disorders, brain tumours and strokes. The relationship between clinically detectable body asymmetry (BA) and the electro-anatomic characteristics of their epilepsy was explored. Body asymmetry was found in 88 out of 282 cases, in which 64 (73.5%) suffered from localisation related epilepsy. Among localisation related epilepsy, BA were found in 41.5% (n=64/154) of patients. In contrast, only 18.75% (n=24/128) of patients with generalised seizure disorders showed similar findings (P<0.0001). Among patients with partial onset seizures, lateralisation of BA was concordant with their seizure origin in 75.9% (n=41/54) and discordant in 24.1% (n=13/54). Investigation results of 10 partial epilepsy cases were non-lateralising at the time of study. Peak age of onset of concordant case was 0-5 years old while discordant group was 6-15 years old. We conclude that BA in patients with seizure disorder is a useful clue to diagnosis of localisation related seizure and may provide clues for lateralising seizure origin in partial onset seizures.     

Studies on tubercle bacillus-monocyte relationship. II. Induction of monocyte degeneration by bacteria and culture filtrate: specificity of serum and monocyte effects on resistance to degeneration

Studies of virulent, attenuated, and avirulent strains of tubercle bacilli have demonstrated the proficiency of virulent strains to effect degeneration of normal monocytes cultivated in the presence of normal serum. Attenuated strains were less active in this respect, and avirulent bacilli failed to induce monocytic degeneration. Comparison of the effects of virulent H37Rv with O.T., P.P.D., and a culture filtrate of H37Rv revealed a similarity in action of H37Rv and its filtrate. The action of O.T. and P.P.D. differed from that of H37Rv in that the greatest effect of H37Rv was upon normal cells as opposed to the effect of O.T. and P.P.D. upon immune cells. Additionally, it was demonstrated that immune serum (anti-BCG) protected immune cells against H37Rv but not against O.T. or P.P.D. The protection of immune cells by heterologous antisera (anti-Salmonella and anti-ovalbumin) as well as by homologous antiserum (anti-BCG) against the degenerative effects of H37Rv indicated a non-specificity in action of serum factors. The ability of the monocytes of animals immunized with BCG and the failure of monocytes of animals immunized with Salmonella rutgers to withstand parasitization with H37Rv, when both types of monocytes were cultivated in immune (anti-BCG) serum, indicated a specificity of cellular resistance.     

Transluminal Angioplasty of the Extracranial Carotid Artery: Indications and Technique—A Multicenter Interventional Neuroradiologist's Perspective

The authors report their experience with transluminal angioplasty of the extracranial carotid artery over the past 14 years. The angioplasty sites included the common carotid artery in 59 patients, the internal carotid artery in 55 patients, and the external carotid artery in 11 patients. The indications for treatment included patients who harbored symptomatic stenosis of 70% or greater, with the majority failing medical therapy and considered poor surgical candidates.     

DUODENAL HAEMATOMA IN ASSOCIATION WITH COELIAC AXIS STENOSIS

Duodenal haematoma is now a welt-established clinical entity. The aetiology, however, is not always clear. Trauma or bleeding due to anticoagulant therapy is the cause in most cases. It is suspected that unreported minor trauma may cause the remainder. A case is reported in which the pancreaticoduodenal circulation was markedly dilated and tortuous because of severe coeliac axis stenosis. It is suggested that no trauma is required in this situation to cause bleeding, which may be due to spontaneous rupture of the smaller vasa recta.     

A case of refractory vasculitic ulcers in a systemic lupus erythematosus patient responding to rituximab and hyperbaric oxygen therapy

Large refractory vasculitic ulcers are not commonly seen in systemic lupus erythematosus (SLE) patients. We report a case of refractory vasculitic ulcers responding to rituximab, a monoclonal antibody directed against CD20 cells leading to prolonged B cell depletion. This treatment was initiated after treatment with high‐dose steroids and other immunosuppressants were ineffective/associated with significant side‐effects. Following treatment with rituximab, there was sustained clinical improvement and subsequent reduction of prednisolone dose. Rituximab was well‐tolerated. Concomitant methotrexate therapy and hyperbaric oxygen therapy (HBOT) may have aided the recovery of the patient’s vasculitic ulcers. This case and anecdotal reports have illustrated the efficacy and safety of rituximab in the treatment of refractory SLE‐related vasculitic ulcers. Further studies to determine the long‐term efficacy and side‐effects would be useful.     

食管胃一层缝合法的探讨

 目的　防止食管吻合口狭窄 ,提高病人的生存质量 ,探讨胃食管一层缝合的可行性。方法　 1995年 1月～ 1999年 6月 ,行食管、近端胃切除 ,食管胃采用一层缝合方法共 52例。结果　全组无死亡 ,吻合口瘘 1例 (颈部食管胃吻合 ,经保守治疗全愈 )占 1 9%。术后 6月行钡餐检查吻合口直径≥ 1cm。仅 3例进食时有不适之感 ,对生存质量无影响。结论　食管胃吻合采用一层缝合方法是可行的。对防止吻合口狭窄 ,提高病人生存质量是有效的。并能降低吻合口瘘的发生。     

福建省城乡15岁以上人群乳牙滞留状况抽样调查分析

目的：了解福建省居民乳牙滞留状况及分布规律，为临床滞留乳牙的治疗及口腔健康流行病学抽样调查提供参考。方法：采用多阶段、分层、整群随机抽样的方法调查了15岁、18岁、35～44岁、65～74岁年龄组8528人的乳牙滞留情况。结果：15岁、18岁、35～44岁、65～74岁年龄组乳牙滞留率为1．41％、1．31％、0．38％、0。其中年龄最大为36岁，单人滞留牙最多为4颗，以下颌第二乳磨牙和上颌尖牙最常见。结论：对没有恒牙胚的滞留乳牙，可尽量保存，对有恒牙胚的可拔除滞留乳牙，引导恒牙萌出。在进行口腔健康流行病学抽样调查时应考虑乳牙滞留问题。     

Prevalence and Factors Associated with Concomitant Chinese Medicine Use by Rheumatoid Arthritis Patients in A Multi-Ethnic Asian Population

Objective:To determine the prevalence,factors associated with and patterns of concomitant Chinese medicine(CM)with Western treatment use among patients with rhe...