Slowly progressive hemiparesis in childhood as a consequence of Rasmussen encephalitis without or with delayed-onset seizures

Five young children developed slowly progressive hemiparesis as the initial manifestation of Rasmussen encephalitis (RE). Three have remained seizure free over an observational period of 1.3–1.9 years. In the remaining two patients, seizures occurred after 0.5 and 0.6 years respectively. We suggest that RE might be presently underdiagnosed and should be suspected in cases of new onset hemiparesis. In this series, three out of five patients showed oligoclonal bands on examination of cerebrospinal fluid (CSF) which represented additional diagnostic hints towards an immune-mediated condition. According to recently published formal diagnostic criteria, evidence of progressive cerebral hemiatrophy or bioptic identification of RE-typical inflammation confirms the diagnosis in such cases. Long-term immunotherapy is recommended in order to prevent further tissue loss and functional decline.     

用混合粘合剂碳糊电极测定丁螺环酮

用混合粘合剂碳糊电极测定丁螺环酮张正奇，曾鸽鸣，刘传桂，黎艳飞（湖南大学化学化工系，长沙４１００８２）碳糊电极无毒，制作方便，表面更新容易，应用电位范围广，在药物分析中已有应用［１～５］。我们在液体石腊中加入添加剂，组成混合粘合剂，可显著改善电极的检...     

Value of digital volume tomography in patients with conductive hearing loss

Digital volume tomography (DVT) is an extension of panoramic tomography. With this diagnostic technique, characterized by high resolution, a narrow section width (0.125 mm) and three-dimensional display, small pathological processes can be well visualized. Twenty-five patients with the history of a progressive hearing loss were examined with DVT (Accu-I-tomo, Morita, Japan). The results were compared with pre- and intraoperative findings to evaluate the diagnostic value of DVT in cases of erosion of the ossicular chain. With high resolution and artifact-free demonstration of the middle ear and the ossicular chain, it was possible to define its continuity preoperatively by DVT in all 25 cases. An intact ossicular chain was found by DVT in 13 cases and was later confirmed by surgery. The predicted erosion of the ossicles was verified in 12 patients, and a tympanoplasty type III was performed. Digital volume tomography is an excellent technique to examine the middle ear cleft and inner ear, and expands the application of diagnostic possibilities in the lateral skull base. Therefore, improvement in preoperative diagnosis is achieved along with more accurate planning of the surgical procedure. Digital volume tomography delivers a small radiation dose with a high resolution and a low purchase price for the equipment.     

Viral infections in the mouth

Oral hairy leukoplakia (OHL) and Kaposi's sarcoma (KS) are commonly encountered in the HIV-infected patient. A unique feature of OHL is non-cytolytic high level of replication of Epstein–Barr virus (EBV) in the glossal epithelium. The expression of viral-encoded anti-apoptotic proteins concomitant to replicative proteins probably underlies this phenomenon. The question of whether OHL arises from activation of EBV latent in the tongue, or from superinfection by endogenous EBV shed via non-glossal sites or by exogenous EBV remains unresolved. Human herpesvirus 8 (HHV8) is now seen as necessary but not sufficient cause of KS. Expression of HHV8-encoded oncogenic proteins in endothelial cells probably explains the aberrant proliferation of these cells in KS lesions. Studies into why KS is so commonly observed at the palate in HIV-infected patients may provide important clues to its pathogenesis.     

Utilization of preoperative cerebrospinal fluid drain in skull base surgery.

OBJECTIVE: Retrospectively assess the efficacy of lumbar cerebrospinal fluid (CSF) drainage placed preoperatively in skull base operations in decreasing the incidence of postoperative CSF fistula. METHODS: A retrospective review of 150 patients undergoing a posterior fossa craniotomy from 1989 to 2000 was conducted. Patients were divided into those receiving preoperative lumbar drains and those that did not. The rates of postoperative CSF leakage were compared between the two groups. Patient data were analyzed to determine if there were other comorbidities affecting the postoperative incidence of CSF leakage such as smoking, diabetes, or hypertension. RESULTS: Between 1989 and 1994, 25/72 (35%) patients with no preoperative lumbar drain had a postoperative CSF leak. From 1995 to 2000, 9/78 (12%) patients with a preoperative lumbar drain had a CSF leak. This was a 23% decreased incidence of postoperative CSF leakage and a significant decrease in the probability (p < 0.001) of CSF leakage in patients treated with a preoperative lumbar drain. The comorbidities of diabetes, smoking, or hypertension did not increase the probability of a CSF leak (p = 0.43). CONCLUSIONS: A preoperatively placed lumbar drain can significantly lower the rate of postoperative CSF leakage after skull base surgery. The drain is a well-tolerated adjunct to dural closure and helps increase surgical exposure of the posterior fossa. The comorbidities of diabetes, smoking, or hypertension do not contribute to an increased rate of CSF leakage.dagger Lyal Leibrock M.D., F.A.C.S. is Deceased.     

真空紫外辐照对加成型硅橡胶光学性能的影响

考察了加成型硅橡胶在真空环境中经1000ESH紫外辐照后的性能变化。结果表明,辐照后材料均出现发黄的现象,光学透过率大幅度 下降,同时加入硅酸钾包覆后制备的热控涂层反射率下降。经原位测试与离位测试,发现加成型硅橡胶在两种不同条件下测得的结果差异较小,而在有机硅橡胶中加入ZnO后原位与离位测试结果则差异明显,表现出明显的漂白作用。     

High hydrostatic pressure effects onSpirostomum ambiguum

The effects of hydrostatic pressure on the ciliateSpirostomum ambiguum, when the organism is uncalcified in the early stage of culture and when it is calcified after periods of time are described. Uncalcified cells are sensitive to pressure, becoming quiescent at 250 atm, distorting at 300 atm and disrupting at 550 atm. In contrast, the mature calcified animals show no changes at 550 atm. and small temporary increases in diameter only during 2 hr of treatment at 1000 atm.

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Zusammenfassung Es wird der Einfluß von hydrostatischem Druck auf die CiliatenSpirostomum ambiguum beschrieben, einerseits auf nicht verkalkte, im frühen Stadium der Kultur stehende Infusionen, anderseits auf verkalkte, längere Zeit gewachsene Mikroorganismen. Nicht verkalkte Zellen sind druckempfindlich; bei 250 Atm. verlieren sie ihre Mobilität, bei 300 Atm. verändern sie ihre Form und bei 550 Atm. platzen sie. Im Gegensatz dazu weisen die ausgewachsenen verkalkten Tiere bei 550 Atm. keine Veränderungen auf; nach Einwirkung von 1000 Atm. während 2 Std zeigen sie nur eine kleine vorübergehende Zunahme ihres Durchmessers.

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Résumé Les effets de la pression hydrostatique ont été étudiés surSpirostomum ambiguum cilié, à un stade précoce du culture, lorsqu'il n'est pas calcifié et plus tardivement lorsqu'il est calcifié. Les cellules non calcifiées sont sensibles à la pression. Elles deviennent inertes à 250 atm.; elles changent de forme à 30 0atm. et elles éclatent à 550 atm. Par contre, les organismes calcifiés adultes ne sont pas altérés à 550 atm. et ne présentent qu'une faible augmentation transitoire de diamètre qu'au bout de 2 heures de traitement à 1000 atm.