Endogenous dopaminergic asymmetry affects development of seizures kindled in the rat amygdala

Cerebral dominance in 56 rats was determined by observing the direction of their turning behavior in response to injection of d-amphetamine (1.5 mg/kg, i.p.). Rats subsequently subjected to kindling of the amygdala developed full epileptic seizures after significantly fewer kindling sessions if the kindling electrodes were in the amygdala of the nondominant, rather than the dominant hemisphere. Kindling rate also showed a significant negative correlation with the total amount of turning after amphetamine. Rats kindled through electrodes in the ventral mesencephalon generally failed to develop full convulsive seizures, and did not show interhemispheric differences in the rate at which they developed preictal behaviors. As the dominant hemisphere of the rat, identified by rotational preference, contains a higher concentration of dopamine, we conclude that even small differences in dopaminergic activity, within the normal physiologic range, can affect the relative susceptibility of the two hemispheres to the development of kindled epilepsy.     

Endoscopic Reconstruction of Cranial Base Defects following Endonasal Skull Base Surgery.

The expanded endonasal approach provides access to the entire ventral skull base for resection of neoplasms involving the skull base and brain. The creation of large defects of the bone and dura endoscopically presents unique reconstructive challenges. A layered reconstruction of the dura with inlay and onlay fascial grafts covered with fat grafts is an effective technique for repair. An intranasal balloon catheter is used to provide counterpressure in the early phase of healing and a lumbar spinal drain is a useful adjunct in patients at increased risk of a cerebrospinal fluid leak. Vascularized flaps may be necessary in some patients receiving radiation therapy. Continued advances in surgical technology and the introduction of new biomaterials will facilitate the reconstruction of skull base defects following endonasal brain surgery.     

颈内动脉接近完全闭塞时的处理

目的由于卒中风险随着狭窄严重程度的增加而升高，因此认为颈内动脉（ICA）接近闭塞患者的卒中风险很高。在现有的随机试验中，还没有专门针对这种情况进行探讨，因此其处理尚存在争汶。方法：对相关文献进行系统评价。结果：对ICA接近闭塞患者的处理还存在争议：一些学者支持进行干预，而另一些学者则认为存在风险或没有益处而反对进行干预。在ICA接近闭塞的有症状患者中进行一项比较外科治疗与最佳内科治疗的多中心前瞻性随机试验似乎非常困难，因为这类研究需要大量的患者。尽管如此，基于目前的证据，似乎很难拒绝手术治疗。结论：由于目前对ICA接近闭塞患者的最佳处理方案仍存在着争议，因此需要前瞻性观察性研究以证实其在有症状和无症状人群中的患病率以及相关的卒中风险。基于目前的证据，大多数医疗中心选择手术治疗，但它相对干内科治疗的特粱尚右待证章．     

T2 hyperintense foci on magnetic resonance images of schizophrenic patients and controls.

High resolution magnetic resonance imaging (MRI) of the brain was performed on 18 male schizophrenic patients and 15 male normal control subjects using an identical imaging protocol. The number and size of T2 hyperintense foci were clinically quantified by an academic radiologist. Large foci (greater than or equal to 3 mm in diameter) were observed more frequently on patient images (7/18) than on control images (1/15). The imaging protocol detected high rates of focal hyperintensities, but no differences between patients and controls were noted in the total affected brain area (sum of focal areas) or in the presence or absence of foci.     

Unusual Physiologic Melanin Pigmentation of the Tongue

A patient had extensive congenital oral hyperpigmentation of the tongue. The clinical and histologic features set this case apart from any well-delineated disease. Clinically, the congenital onset, the appearance of large black-brownish lesions, the lack of associated systemic abnormalities, and the histologic findings of prominent deposition of melanin in the basal layer support the diagnosis of physiologic melanosis. The macular lesions of the tongue represent discrete depositions of melanin and exemplify soft tissue pigmentation of developmental origin.