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101.
M. J. Fritsch M. Bauer C. J. Partsch W. G. Sippell H. M. Mehdorn 《Child's nervous system》2007,23(6):627-631
Objective Endoscopic third ventriculostomy (ETV) is a standard procedure for the treatment of obstructive hydrocephalus in children.
Main part of the procedure is the perforation of the third ventricle floor (tuber cinereum). This structure is part of the
hypothalamic–pituitary neuronal network of cerebral endocrine regulation. There are no systematic data available about the
endocrine status after ETV in children.
Materials and methods We examined 20 children who had undergone ETV. Examination included laboratory tests (adrenocorticotropic hormone, prolactin,
insulin-like growth factor 1 [IGF-1], IGF-binding protein 3 [IGFBP-3], fT3, fT4, thyroid-stimulating hormone [TSH], serum
osmolarity, electrolytes, glucose, urea, follicle-stimulating hormone [FSH] and luteinizing hormone [LH], and testosterone
in selected patients), measurement of weight, height, and head circumference, and physical examination. The study was approved
by the Ethics Committee of the Medical Faculty of Kiel University.
Results In seven patients, prolactin was moderately elevated. One patient demonstrated a significantly increased prolactin (56.3 ng/ml).
In all eight patients, this was the only laboratory value that was out of the normal range; all other parameters were normal.
Three other patients showed one abnormal parameter (decrease in FSH and LH, increase in TSH, decrease in IGF-1 and IGFBP-3).
In nine patients, weight or height was not within the 3rd to 97th centiles for age.
Discussion and conclusion More patients than expected demonstrated endocrine laboratory abnormalities. However, there was no clinical relevance in any
of the studied patients. It remains inconclusive whether ETV contributes to the abnormalities of prolactin levels or to other
endocrine parameters in pediatric patients. Longitudinal studies are necessary to delineate the effect of ETV on endocrine
regulation.
Presented at the Third World Conference of the International Study Group on Neuroendoscopy (ISGNE), Marburg, Germany, 15–18
June 2005. 相似文献
102.
Hoon-Chul Kang Ji Won Kwon Young Mock Lee Heung Dong Kim Hong Jin Lee Si Houn Hahn 《Child's nervous system》2007,23(11):1301-1307
OBJECTIVES: This study sought to characterize epileptic phenotypes in children with nonspecific mitochondrial disease (MD) and to evaluate MD diagnostic approaches. METHODS: A retrospective analysis of the medical, electroencephalogram, and laboratory records of 142 patients with epilepsy was performed. The patients were evaluated for MD, and 124 patients were included in the final cohort. The MD criteria used included an oral glucose lactate stimulation test (OGLST) and urine organic acid/plasma amino acid (UOA/PAA) assays as metabolic indicators of modified Walker criteria, as suggested by Bernier et al. (Neurology 59:1406-1411, 2002). RESULTS: Twenty-two patients were classified as having definite MD (9), probable MD (5), possible MD (6), or pyruvate dehydrogenase (PDH) deficiency (3), including one patient which showed a respiratory chain (RC) defect and PDH deficiency. Seven out of eight patients in whom significant RC defects were observed showed complex I defects. In 14 patients, epileptic seizures start at infantile ages. Of 17 patients who substantially presented generalized seizures, 4 patients started with partial seizures. Five patients consistently presented only partial seizures. The OGLST and UOA/PAA assays were useful for a more precise diagnosis of MD, although low positive predictive value of the OGLST was regrettable. No patient was classified as definite MD by Walker's original criteria, but the use of our revised MD criteria resulted in the classification of nine additional patients as definite MD. CONCLUSIONS: MD manifested considerable diverse epileptic phenotypes and should be considered in the differential diagnosis of epilepsy in children with unexplained encephalomyopathy and progressive and fluctuating clinical courses. 相似文献
103.
104.
Dan Greitz 《Child's nervous system》2007,23(5):487-489
Objective This study aims to question the generally accepted cerebrospinal fluid (CSF) bulk flow theory suggesting that the CSF is exclusively
absorbed by the arachnoid villi and that the cause of hydrocephalus is a CSF absorption deficit. In addition, this study aims
to briefly describe the new hydrodynamic concept of hydrocephalus and the rationale for endoscopic third ventriculostomy (ETV)
in communicating hydrocephalus.
Critique The bulk flow theory has proven incapable of explaining the pivotal mechanisms behind communicating hydrocephalus. Thus, the
theory is unable to explain why the ventricles enlarge, why the CSF pressure remains normal and why some patients improve
after ETV.
Hydrodynamic concept of hydrocephalus Communicating hydrocephalus is caused by decreased intracranial compliance increasing the systolic pressure transmission into
the brain parenchyma. The increased systolic pressure in the brain distends the brain towards the skull and simultaneously
compresses the periventricular region of the brain against the ventricles. The final result is the predominant enlargement
of the ventricles and narrowing of the subarachnoid space. The ETV reduces the increased systolic pressure in the brain simply
by venting ventricular CSF through the stoma. The patent aqueduct in communicating hydrocephalus is too narrow to vent the
CSF sufficiently. 相似文献
105.
Christian Waydhas Dieter Nast-Kolb Steffen Ruchholtz 《European journal of trauma and emergency surgery》2007,33(2):170-175
Abstract
Objective: To define the diagnostic accuracy of clinical examination in patients with impaired consciousness or endotracheal intubation
to detect pelvic ring fractures and to identify those with severe bleeding.
Methods: Included in this prospective data collection with retrolective data analysis were a consecutive series of blunt trauma victims
with either a Glasgow Coma Scale ≤ 13 or tracheal intubation. Clinical examination comprised testing for stability of the
iliac wings.
Results: From 784 subjects (injury severity score 23.3 ± 17.4) 93 patients (11.9%) were found to have a pelvic ring fracture. Clinical
instability of the pelvic ring was found in 42 patients. There was only one false positive. Fifty-two fractures could not
be identified by clinical examination, including nine fractures (17%) that required surgical fracture stabilization (sensitivity
of clinical examination 44.1%). Seventeen fractures (18.3%) were associated with a blood loss larger than 20% of circulating
blood volume. Sixteen of those were identified by clinical instability of the pelvic ring (sensitivity 94.1%, specificity
97.0%, positive predictive value 38.1%, negative predictive value 99.9%).
Conclusions: Clinical examination for stability of the pelvis in this selected group of patients missed a significant number of pelvic
ring fractures including fractures that require surgical stabilization. The finding of a clinically unstable identifies most
of the patients with the pelvic ring fracture being a major source of bleeding. A stable pelvis makes pelvic ring fracture
as being the source of bleeding quite unlikely. 相似文献
106.
The regional distribution of the phenylalanine-sensitive ATP-sulphurylase in fetal calf brain coincides with demyelinated lesions observed in the central nervous systems of untreated PKU patients. This would be expected if this species of ATP-sulphurylase played a role in the pathogenesis of brain dysfunction in the untreated or poorly controlled phenylketonuria patient. 相似文献
107.
Background
Reports on childhood cancer survivors estimated cumulative probability of developing secondary neoplasms vary from 3,3% to 25% at 25 years from diagnosis, and the risk of developing another cancer to several times greater than in the general population. 相似文献108.
P. Priego E. Lobo G. Rodríguez J. Cabañas J. Pérez de Oteyza V. Fresneda 《Clinical & translational oncology》2007,9(2):106-109
Abstract
Background and study aims: The advent of endoscopic techniques in the last decades has produced a change in the approach of the oesophageal leiomyoma.
The aim of the study is to explain our experience in the laparoscopic surgery of the oesophageal leiomyoma.
Materials and methods: We realised a retrospective study of the oesophageal leiomyoma operated on in our centre by the endoscopic approach between
2001 and 2004. There were two females and two males. All were symptomatic and pyrosis was the most frequent symptom. The preoperative
study was an oral endoscopy and barium swallow. In all the cases enucleation was performed, two by thoracoscopy and two by
laparoscopy approach.
Results: The mean operating time was 230 min. No deaths or intraoperative complications occurred and there were no cases of conversion
to open surgery either. The mean postoperative hospital stay was 3.25 days (range 2–4 days). There was no case of recurrence.
Conclusions: The enucleation is an easier procedure and constitutes the therapy of choice of the oesophageal leiomyoma. We think that muscle
borders should be closed after enucleation and that biopsy is not indicated preoperatively. 相似文献
109.
G. B. Slepchenko L. S. Anisimova V. F. Slipchenko E. V. Mikheeva N. P. Pikula 《Pharmaceutical Chemistry Journal》2005,39(3):166-168
Rapid voltammetric procedures for the determination of water-soluble vitamins C, B1, and B2, fat-soluble vitamin E (α-tocopherol acetate), and quercetin in bioactive food additives have been developed. The systematic error (i.e., correctness) of the proposed procedures was evaluated using certified reference materials and the additive recovery tests, which gave the following limiting metrological characteristics: relative error, 25 %; reproducibility, 28 %; convergence, 22 %. The full analysis time (with sample preparation) did not exceed 2 hours. Voltammetric determinations under optimum conditions can be performed in the automated regime controlled by a computer according to the specially developed software.__________Translated from Khimiko-Farmatsevticheskii Zhurnal, Vol. 39, No. 3, pp. 54 – 56, March, 2005. 相似文献
110.
The influence of chronic administration of a dry cleared extract of Glycyrrhiza glabra (DCEG) containing flavonoids on the behavioral status and learning of intact and ovariectomized adult female rats has been
studied. The DCEG preparation was administered in low (0.5 mg/kg, i.p.) and high (5.0 mg/kg, i.p.) daily doses over a period
of 14 days and the results were evaluated on the passive avoidance situation model and in the open field test. It was established
that the chronic administration of DCEG in both low and high doses produced correction of the passive avoidance performance
in ovariectomized female rats. The administration of DCEG in a low dose also positively influenced the structure of purposeful
behavior of females with deficiency of estrogens.
__________
Translated from Khimiko-Farmatsevticheskii Zhurnal, Vol. 39, No. 8, pp. 27 – 29, August, 2005. 相似文献