Open, Double-Blind and Long-Term Study of Vigabatrin in Chronic Epilepsy

We performed an open, double-blind, and long-term study of vigabatrin (gamma-vinyl-GABA, GVG) in patients with treatment-resistant epilepsy who were receiving only one or at most two standard antiepileptic drugs (AEDs). The novel design included a parallel, double-blind, placebo-controlled phase that minimized the number of patients receiving placebo and allowed determination of the optimum dose of GVG for each patient before initiation of the double-blind phase. The study was divided into four phases. The first phase was a 6-week period of baseline observation. In the second phase, GVG was added openly to previous AEDs for 8 weeks. During the first 2 weeks of this phase, the dose of GVG was increased weekly and then, in the absence of adverse effects, was held constant for the next 6 weeks. At the end of this open phase, seizure frequency during the 6 weeks of constant treatment was compared with the baseline seizure frequency for each patient. Patients who experienced reduction greater than 50% in the frequency of any seizure type during the open phase were defined as responders. These responders were then entered into the third and double-blind phase, in which they were randomly allocated wither to continue active GVG treatment or placebo for 8 weeks. Thirty-three patients entered the study; 31 of 33 patients completed the initial open phase. Twenty patients achieved a reduction greater than or equal to 50% in the frequency of one or more seizure types and were eligible for the double-blind phase; 10 were randomized to continue GVG and 10 were randomized to placebo.(ABSTRACT TRUNCATED AT 250 WORDS)     

Status of Women and Infants in Complex Humanitarian Emergencies

Women and children bear the greatest burden in the midst of war and long‐term disasters. Complex humanitarian emergencies are characterized by social disruption, armed conflict, population displacement, collapse of public health infrastructure, and food shortages. Humanitarian assistance for refugees and internally displaced populations requires particular attention to the common issues affecting morbidity and mortality in women and infants. Gender‐based violence and reproductive health concerns are discussed within the context of populations affected by conflict and forced migration. Recommendations for midwives and women's health care providers engaging in care for women and children in complex humanitarian emergencies are discussed.     

A Thalamic Contribution to Arousal-induced, Non-photic Entrainment of the Circadian Clock of the Syrian Hamster

It is well established that the circadian clock of the suprachiasmatic nuclei (SCN) is entrained by light. More recently, the potent effects of arousing, non-photic cues on the clock have been recognized. The neural mediators of non-photic entrainment are yet to be identified. To examine the contribution of the thalamic intergeniculate leaflet (IGL) and its NPY-immunopositive projection, the geniculo-hypothalamic tract to non-photic entrainment by arousal, male Syrian hamsters received lesions of the IGL (IGLX) which ablated NPY-immunoreactivity in the SCN. Their circadian responses to both photic and non-photic cues were then tested. Lesions resulted in a delay in the timing of activity onset following lights out, but had no effect on the behavioural or cellular circadian responses to phase-advancing light pulses presented at circadian time (CT) CT19 (where CT12 represents the time of activity onset). Injection with a benzodiazepine (chlordiazepoxide, 100 mg/kg) at CT6 suppressed wheel-running, increased general locomotion of intact controls and induced large phase advances of the circadian rhythm of wheel-running. Chlordiazepoxide also inhibited wheel-running in lesioned animals, but there was no significant increase in general locomotion and the lesioned animals did not phase advance. Serial arousal by injection of saline at intervals of 23.5 h for 6 days entrained the circadian rhythm of wheel-running of intact hamsters and was associated with an increase in general locomotor activity. Entrainment by serial arousal was abolished by IGLX. However, the lesioned animals did show a clear behavioural response to every presentation of the non-photic cue. These results show that the IGL is a necessary component of the neural pathways mediating both arousal- and benzodiazepine-induced non-photic entrainment.     

基于美军二战海战减员数据的校正

目的：通过对二战减员数据的校正，为下一步建立海战减员预计模型提供数据支持．方法：选取美军在二战太平洋海战中的减员数据作为研究的基本资料，通过专家咨询法(Delph method)对其进行校正，所有结果都对其进行了t检验．结果：水面舰艇遭受炸弹、舰炮及航空火炮、短程导弹、鱼雷和水雷的攻击时减员将减少，遭受中程导弹攻击时减员将会增加．结论：该校正结果可作为研究未来海战卫生减员预计的基本依据之一．     

Long-term results of surgically treated traumatic rectourethral fistulas

OBJECTIVE: Rectourethral fistulas are uncommon, usually iatrogenic injuries that are demanding to treat. We present the challenging problems involving the treatment of rectourethral fistulas caused by war wounds. MATERIALS AND METHODS: In the period 1991-1996, during the war in Croatia and Bosnia, six patients with rectourethral fistulas caused by war injuries were operated in our institution by the same surgeon. All patients were young males with a mean age of 24.6 years. In all patients, double diversion (diversion colostomy and cystostomy) was performed at the time of the injury in military hospitals. In three patients, multiple unsuccessful operations were performed in other institutions to close rectourethral fistula. We found urethrocystography and proctoscopy as the most reliable diagnostic studies and performed them in all patients. In first three patients, we performed transanal repair with anterior rectal wall advancement flap. Because it failed in all three patients, we performed York-Mason trans-sphincteric approach and anterior rectal wall advancement flap after which rectourethral fistula closed in all patients. Because of the satisfactory results, we performed the same procedure in other three patients. RESULTS: In all patients rectourethral fistula healed 2 months after the operation. Closure of diverting colostomy was performed after urethrocystography and proctoscopy proved that the rectourethral fistula has healed. There were no operative deaths and no major complications. Urethral stenosis developed in one patient and was successfully managed by dilatation. CONCLUSION: We believe that York-Mason trans-sphincteric approach offers straightforward access through healthy tissues and good fistula visualization. Anterior rectal wall advancement flap can easily be performed and offer good chances for definitive closure of the rectourethral fistula.     

Risperidone exerts potent anti-aggressive effects in a developmentally immature animal model of escalated aggression.

BACKGROUND: Risperidone has been shown to be clinically effective for the treatment of aggressive behavior in children, yet no information is available regarding whether risperidone exhibits aggression-specific suppression in preclinical studies that use validated developmentally immature animal models of escalated aggression. Previously, we have shown that exposure to low doses of the psychostimulant cocaine-hydrochloride (.5 mg/kg intraperitoneally) during the majority of pubertal development (postnatal days [P]27-57) generates animals that exhibit a high level of offensive aggression. This study examined whether risperidone exerts selective aggression-suppressing effects by using this pharmacologic animal model of highly escalated offensive aggression. METHODS: Experimental hamsters were tested for offensive aggression after the acute administration of risperidone (.05-1.0 mg/kg, intraperitoneally). RESULTS: Risperidone dose-dependently reduced the highly aggressive phenotype, with a significant reduction observed at .1-.2 mg/kg for most aggressive responses measured. Experimental animals treated with higher doses of risperidone (.3-1.0 mg/kg) showed significant reductions in aggression and social interest toward intruders, indicating more general behavioral inhibition. CONCLUSIONS: These studies provide evidence that risperidone exerts specific aggression-suppressing effects in a developmentally immature animal model of escalated aggression.     

关于军工研究所发展民品产业的几点思考

探索军工研究所发展民品产业之路.本文对军工研究所发展民品产业进行了优劣势分析,继而从机制转换,组织结构,产品战略,市场营销,人才队伍建设等方面提出了一些改革措施.