Seizures with Onset in the Sensorimotor Face Area: Clinical Patterns and Results of Surgical Treatment in 20 Patients

Summary: It is not generally appreciated that intractable seizures involving the face area are amenable to surgical treatment. Twenty patients with onset of sensorimotor seizures in the face area of the pre- and postcentral gyri have been studied and surgically treated since 1948. Seizures started in the face, tongue, or throat, followed by diverse patterns depending on spread of seizure activity. Two patients had epilepsia partialis continua; 6 had either tonic or atonic drop attacks. All patients had pre- and postcentral face area resections, 12 in the dominant hemisphere. In addition, 3 had more extensive postcentral removal, 7 had temporal lobe, and 4 had small separate or contiguous frontal or parietal resection. Because the seizures were not sufficiently reduced by the first operation, 6 required reoperation; 4 of these patients had residual epileptiform activity on electrocorticogram (ECoG) after the first resection. Three patients had new neurologic signs that did not return to the preoperative level, but in 2 of them the deficit related mainly to higher resection in the central area. All but 2 of these 20 patients had at least moderate seizure reduction. Corticectomy can be performed for treatment of seizures arising in the lower central area and usually does not lead to significant permanent neurologic deficit.     

13-cis-retinoic acid (NSC 122758) in the treatment of children with metastatic neuroblastoma unresponsive to conventional chemotherapy: Report from the childrens cancer study group

The Childrens Cancer Study Group evaluated daily oral 13-cis-retinoic acid to determine its therapeutic efficacy in 28 children with advanced neuroblastoma refractory to conventional therapy. Cheilitis and fissured lips were the most common side effects; however, fewer than 50% of the patients experienced any toxicity. Two of twenty-two evaluable children demonstrated positive response to therapy. In one case, a child received the drug for 11 months. Seventeen patients demonstrated progressive disease within 28 days of the start of treatment. Three other patients with stable disease, or removed from study at day 28, were considered nonresponsive. Our data demonstrate that, when given as a single daily oral dose of 100 mg/m², 13-cis-retinoic acid does not have significant activity in children with advanced neuroblastoma. © 1992 Wiley-Liss, Inc.     

An improved technique for treating tracheostomal stenosis following laryngectomy

Stenosis of the tracheostome is an occasional complication following laryngectomy. Having tried a number of procedures recommended for correction of such stenoses with limited results, we developed a new technique. This technique which is based on multiple Y-V plasties has been applied to 20 patients. Measurements of the stomal area following surgery in 18 patients showed an average increase in stomal size by a factor of 3.8. One patient apparently had no increase of the stoma. In 2, no post-operative measurements were available. Post-operative infection resulted in recurrence of the stenosis in one patient. He was successfully reoperated using the same technique. Follow-up revealed that none of the patients had complaints related to their stoma.     

医学技术的进步与传统医学伦理的矛盾

此文全面论述了先进医学技术给传统医学伦理的医患关系模式、医生义务论、生命认识论、资源分配论等诸多方面带来的巨大冲击,并由此提出先进医学技术发展应遵循的伦理规则。     

双语教学Powerpoint课件制作探讨

针对Powerpoint软件在课件制作上常存在的屏幕背景与文字色彩对比不当、文字数量太多及字体太小、文字动画太多且乱、声音混杂等问题,结合实践就如何制作课件,尤其是双语教学课件,从总体布局、屏幕文字安排、背景与版式的设计、声音与动画等方面进行了探讨,并介绍了多种特殊效果的应用技巧.     

M-2 protocol for melphalan-resistant and relapsing multiple myeloma

33 patients with advanced refractory multiple myeloma received a combination of vincristine, cyclophosphamide, carmustine, melphalan and steroids (M-2 protocol). 20 of them had failed prior chemotherapy with alkylating agents and the remaining 13 patients had relapsed after a response to these drugs. An objective tumour cell mass reduction (greater than or equal to 50%) was achieved in 17% of the patients (6% of previously nonresponders and 33% of previously relapsing), while 9 additional patients improved (30-50% tumour reduction), for an overall response rate of 47% (39% for previously nonresponders and 58% for previously relapsing). The median duration of response was 7 months. Thrombocytopenia was the most common toxicity encountered in the study (39% of cases). Our findings indicate that M-2 protocol is an effective salvage treatment for patients who relapse from previous chemotherapy with alkylating agents. In contrast, results in patients who are primarily resistant to these drugs justify the search for different treatment programmes which can produce greater degrees of tumour reduction.     

THE EFFECT OF ACUPUNCTURE ON PREVENTION AND TREATMENT OF ISCHEMIC ARRHYTHMIA AND THE RELATION BETWEEN EFFECT OF ACUPUNCTURE AND CHOLINERGIC MUSCARINE-LIKE RECEPTORS

For investigating the effect of acupuncture on ischemic arrhythmia and its mech-anism, adult albino rats with ligated anterior descending branch of coronary artery as experimentalmodel were treated with or without acupuncture, and others with imitative operation but without bothcoronary artery ligation and acupuncture treatment were used as control. It was found in acupuncturegroup that the fibrillation-liability of ischemic myocardium was efficiently decreased, the affinity ofAch-M receptors on membranes of ischemic myocardium was markedly increased, and the tolerance ofischemic myocardium to atropine was elevated in the experiment of atropine inducing fibrillation.These results indicate that acupuncture may play a therapeutic role on ischemic arrhythmia throughactivating the activity of muscarine-like receptors of cholinergic nervous system.     

Expanding Our Strategies to Study the Process of Change

The conceptual and methodological framework proposed by Doss (this issue) makes valuable suggestions for strategic choices in future research. This commentary addresses conceptual and terminological distinctions adopted by Doss, as well as his criticism of add-on/ dismantling studies. We also suggest research topics and methodological developments that could be integrated in Doss's framework to further expand understanding of therapeutic change.     

Consistent control of psoriasis by continuous long-term therapy: the promise of biological treatments

Psoriasis is a chronic, incurable disease that frequently requires long-term treatment. Although many patients benefit from effective traditional systemic therapies, namely methotrexate, cyclosporin, retinoids and fumaric acid esters, and some patients achieve long-term disease control, unrestricted long-term administration is not recommended due to the potential for cumulative toxicity. In order to diminish the risk of toxicity, physicians have adopted various treatment approaches (e.g. rotational, sequential, intermittent, and combination). However, these approaches may not provide continuous disease control or a stable treatment regimen. The recent advent of targeted biological therapeutics such as etanercept, infliximab, adalimumab, alefacept and efalizumab may offer physicians and their patients treatment options with improved safety profiles that may permit continuous disease control.     

46例颌骨骨折延迟复位固定的疗效分析

复习46例延迟复位固定的颌骨骨折病例，对延迟复位固定的时间、原因、治疗和愈合情况等进行回顾分析：延迟时间最短2d，最长12d；延迟治疗的原因多种多样，所有病例均采用手术治疗。结果，延迟2～5d复位同定者6例，均一期愈合；延迟5-10d复位同定者31例，27例一期愈合；延迟10-12d复位固定者9例，均一期愈合。