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鼻内接触点头痛和难治性偏头痛患者的外科治疗

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世界核心医学期刊文摘（神经病学分册） 2005年第9期1卷 40-41页

作者： behin F. behin b. bigal M.E. lipton r.b. 周永 142 Palisade Avenue Jersey City NJ 07306 United StatesDr.

Contact point headaches have been attr.b.ted to intranasal contact between opp osing mucosal surfaces, resulting in referred pain in the distr.b.tion of the tr igeminal nerve. In subjects with primary headaches, contact points may be associ ated with treatment refractoriness. We aimed to assess the benefits of surgical correction in patients with refractory migraine or transformed migraine, and rad iographic evidence of contact points in the sinonasal area. We reviewed charts o f patients who underwent endoscopic sinus surgery and septoplasty for contact po int in the same surgical facility, from October 1998 through August 2003. Subjec ts eligible for surgery had: (i) refractory migraine (failed to standard pharmac ological headache treatments) or refractory transformed migraine; (ii) contact p oints demonstrated by computed tomography scan; (iii) reported significant heada che improvement after topical anaesthesia to the contact area. Headache characte ristics were assessed preoperatively and at follow-up (6-62 months after surge ry) using a standardized questionnaire. A total of 21 subjects (72.5%women) wer e assessed. Mean headache frequency was reduced from 17.7 to 7.7 headache days p er month (P=0.003). Mean headache severity was reduced from 7.8 to 3.6 on a 0-1 0 scale (P=0.0001). Headache-related disability was reduced from 5.6 (10-point scale) to 1.8 (P bjects (76.2%) had their headache scores improved by 50%or more; nine (42.9%) were pain free at the last follow -up. A total of 18 (95.8%) had at least a 25%reduction in their headache scor es. Two patients (9.5%) had increase in their headache score by less than 25%. For selected patients with refractory headaches, demonstr.b.e contact points, a nd positive response after topical anaesthesia, surgical approach toward the tri ggering factor may be useful. Prospective studies are necessary to confirm our r esults.

关键词：难治性偏头痛接触点黏膜接触神经分布区内窥镜鼻窦手术鼻中隔成形术放射影像学局部麻醉转换性分量表

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蜂斗菜(款冬)是一种有效预防偏头痛的药物

世界核心医学期刊文摘（神经病学分册） 2005年第5期1卷 34-35页

作者： lipton r.b. Gbel H. Einhupl K.M. 袁海峰 H./Einhton A lbert Einstein College of Medicine Rousso Bldg. 1165 Morris Park Ave. Bronx NY 10461 United States Dr.

Objective: To evaluate the clinical efficacy of a standardized special root e xtract from the plant Petasites hybridus as a preventive therapy for migraine. M ethods: This is a three-arm, parallel-group, randomized trial comparing Peta sites extract 75 mg bid, Petasites extract 50 mg bid, or placebo bid in 245 pati ents with migraine. Eligible patients met International Headache Society criteri a for migraine, were ages 18 to 65, and had at least two to six attacks per mont h over the preceding 3 months. The main outcome measure was the decrease in migr aine attack frequency per month calculated as percentage change from baseline ov er a 4-month treatment period. results: Over 4 months of treatment, in the per -protocol analysis, migraine attack frequency was reduced by 48% for Petasit es extract 75 mg bid (p = 0.0012 vs placebo), 36% for Petasites extract 50 mg bid (p = 0.127 vs placebo), and 26% for the placebo group. The proportion of p atients with a ≥ 50% reduction in attack frequency after 4 months was 68% f or patients in the Petasites extract 75-mg arm and 49% for the placebo arm ( p results were also significant in favor of Petasites 75 mg at 1, 2, an d 3 months based on this endpoint. The most frequently reported adverse reaction s considered possibly related to treatment were mild gastrointestinal events, pr edominantly burping. Conclusions: Petasites extract 75 mg bid is more effective than placebo and is well tolerated as a preventive therapy for migraine. Petasit es 50 mg PO bid was not significantly more effective than placebo on the primary study endpoints.

关键词：蜂斗菜头痛发作提取物国际头痛协会安慰剂临床疗效随机试验

肥胖是转换性偏头痛而非慢性紧张型头痛的危险因素

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世界核心医学期刊文摘(神经病学分册) 2006年第12期 26-26页

作者： bigal M.E lipton r.b. 郭俊 Dr.Department of Neurology Albert Einstein College of Medicine1165 Morris Park Ave.BronxNYUnited States

ObJECTIVE:To assess the influence of the body mass index(bMI)on the prevalence and severity of chronic daily headache(CDH)and its most frequent subtypes,transformed migraine(TM)and chronic tension-type headache(CTTH).METHODS:The authors gathered information on headache,medical features,height,and weight using a computer-assisted telephone *** were divided into five categories,based on bMI:underweight(rmal weight(18.5 to 24.9),overweight(25 to 29.9),obese(30 to 34.9),and morbidly obese(> 35).The prevalence and severity of CDH,TM,and CTTH were *** analyses modeling these diagnoses as a function of bMI were ***:Among 30,215 participants,the prevalence of CDH was 4.1%;1.3%had TM and 2.8%*** contrast with the normal weight group(3.9%),the prevalence of CDH was higher in obese(5.0%[odds ratio(Or)= 1.3,95%CI = 1.1-1.6])and morbidly obese(6.8%[Or = 1.8,95%CI = 1.4 to 2.2]).bMI had a strong influence on the prevalence of TM,which ranged from 0.9%of the normal weighted to 1.2%of the overweight(Or = 1.4 [1.1 to 1.8]),1.6%of the obese(Or = 1.7 [1.2 to 2.43]),and 2.5%of the morbidly obese(Or = 2.2 [1.5 to 3.2]).The effects of the bMI on the prevalence of CTTH were just significant in the morbidly obese *** analyses showed that obesity was associated with CDH and TM but not ***:Chronic daily headache and obesity are *** is a stronger risk factor for transformed migraine than for chronic tension-type headache.

关键词：偏头痛脑病紧张型转换性

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采用支付意愿模式评估偏头痛患者的负担

世界核心医学期刊文摘（神经病学分册） 2005年第6期1卷 18-18页

作者： Hamelsky S.W. lipton r.b. Stewart W.F. 夏峰 bristol- Myers Squibb 1350 Liberty Avenue Hillside NJ 07205 United States Dr.

Willingness to pay methods measure treatment preferences and also measure the burden of illness in economic terms. We used a contingent valuation method to measure migraine sufferers’ willingness to pay (WTP) for acute medication for their most severe headache attacks, based on various profiles of treatment benefits and the characteristics of the migraine sufferer. Subjects were identified from a population- based database of migraine sufferers, previously recruited by random digit dialling. Telephone interviews (n = 1428) were used to gather demographic and headache characteristics. Subjects who met the International Headache Society criteria for migraine with or without aura and satisfied the other inclusion criteria based on telephone interview (n = 312) were invited to participate in a mailed questionnaire study. The questionnaire was mailed to the 310 subjects who agreed to participate and 201 (65% )- surveys were returned. The survey included questions on the demographics, the migraine characteristics, and the psychological disposition of the respondents. WTP for an acute migraine treatment with 14 different hypothetical treatment profiles was explored. responders and non- responders to the survey were generally similar. The newly designed WTP questionnaire had high internal consistency (Cronbach’ s α 0.90) and test- retest reliability (Spearman’ s correlation coefficients 0.71- 0.77). Study subjects were willing to pay a median price of ＄ 5 for a migraine treatment that provided complete relief in 30 min and worked 100% of the time, with no side- effects and no headache recurrence. Median WTP decreased as treatment attr.b.tes deviated from this ideal. For example, WTP declined to a median of ＄ 1 for complete relief in 2 h and to ＄ 0.25 for complete relief in 4 h. All of the medication attr.b.tes powerfully influenced WTP. Several variables predicted WTP including current payment for medication, MIDAS (Grade III), and those with headaches of long duration. Sub

关键词：偏头痛患者支付意愿模式评估头痛发作国际头痛协会电话调查药物治疗统计学资料数据库选择评估法

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SVX/硅条探测器的研究

核电子学与探测技术 1997年第1期17卷 28-32页

作者： L.bagby M.Johnson r.lipton 顾维新 FenmilabNationalAcceleratorLaboratory 中国科学院高能物理所北京100039

交流耦合的硅条探测器有较高的电压跨接在耦合电容上面,坏的耦合电容使约50V 电压加到 SVX 器件,测量了坏的耦合电容对 SVXD(rod soft 3 μm)、SVXH(rad soft 1.2 μm)和 SVX2b(tad soft 1.2 μm)放大器/读出器件的影响.试验结果表明,... 详细信息

交流耦合的硅条探测器有较高的电压跨接在耦合电容上面,坏的耦合电容使约50V 电压加到 SVX 器件,测量了坏的耦合电容对 SVXD(rod soft 3 μm)、SVXH(rad soft 1.2 μm)和 SVX2b(tad soft 1.2 μm)放大器/读出器件的影响.试验结果表明,当一个过载电压直接加到一个 SVX 道时,相邻的一些道发生饱和,这种效应是由于在 SVX 基片内的电流扩散而不是探测器的表面电流形成的。文中讨论了饱和量大小和可能的解决途径。

关键词：硅条探测器 SVX读出器件饱和粒子径迹

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癫痫与偏头痛

国外医学（脑血管疾病分册） 2004年第2期12卷 110-118页

作者： M.E.bigal r.b.lipton J.Cohen S.D.Silberstein 曹立梅李浩毕桂南不详广西医科大学第二附属医院神经内科，南宋530007

偏头痛和癫痫均为慢性疾病，其特征为反复发作的神经症状，可伴有不同的头痛、胃肠道、自主神经和精神症状。偏头痛和癫痫在症状表现、伴发病症(comordity)和治疗方面均存在联系。一种疾病的存在也使另一种疾病存在的可能性增加。另外... 详细信息

偏头痛和癫痫均为慢性疾病，其特征为反复发作的神经症状，可伴有不同的头痛、胃肠道、自主神经和精神症状。偏头痛和癫痫在症状表现、伴发病症(comordity)和治疗方面均存在联系。一种疾病的存在也使另一种疾病存在的可能性增加。另外，很多偏头痛综合征可与癫痫相混淆。对每种疾病的诊断和治疗必须要考虑到存在另一种疾病的可能性。在此，我们对癫痫与偏头痛之间的相互关系进行综述，讨论采用国际头痛协会标准来诊断偏头痛，强调极易误诊为癫痫的偏头痛的变异型。我们还对偏头痛和癫痫的有关流行病学证据作一概述，对偏头痛与癫痫之间特殊的相互关系进行讨论。

关键词：癫痫偏头痛治疗诊断

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HIV白质脑病和神经元TNFα表达的关系

世界核心医学期刊文摘（神经病学分册） 2005年第10期1卷 27-28页

作者： rostasy K. Monti L. lipton S.A. b.A. Navia 李一明 Laboratories of research in Psychiatry Tufts- New England Medical Center 75 Kneeland Street Boston MA 02111 United States Dr.

background: Human immunodeficiency virus (HIV) leucoencephalopathy (HIVL) is an uncommon and rapidly progressive form of AIDS dementia complex (ADC) that has remained poorly understood. Tumour necrosis factor α (TNFα ), which has been implicated in the pathogenesis of ADC, is predominantly localised in macrophages in the HIV infected brain, although in vitro studies indicate that neurones can express this cytokine. Objective: To examine the clinical/neuroradiological fea tures of HIVL and the expression of TNFα in HIVL. Methods: Six patients who pr esented with rapidly progressive dementia within four to 12 weeks of the primary manifestation of their HIV infection were evaluated. Clinical history, treatmen t regimens, and imaging studies were reviewed, and brain samples from three of t he patients were studied by means of immunohistochemistry. results: Imaging stud ies showed diffuse bilateral deep white matter changes in all six patients. Clin ical and imaging abnormalities improved in five of the six patients within weeks after initiation of antiretroviral treatment. brain biopsies of two showed pron ounced microglia/macro- phage activation, but only scant viral protein (gp41) e xpression. Staining for TNFα was found in microglia/macrophages, and surprisin gly, in neurones also. Postmortem analysis of a third patient also showed TNFα expression in neurones of the frontal cortex and basal ganglia. Conclusion: Thi s study provides the first demonstration of staining for TNFα in the neurones of the HIV infected brain, and suggests that the process underlying this rapidly progressive form of ADC may reflect indirect mechanisms mediated by host factor s, particularly TNFα .

关键词：白质脑病 HIV 人免疫缺陷病毒小胶质细胞基底神经节肿瘤坏死因子α 巨噬细胞活化临床病史影像学研究痴呆综合征

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鉴别额颞叶变性和AD的FAb亚评分

世界核心医学期刊文摘(神经病学分册) 2006年第1期 40-41页

作者： lipton A.M. Ohman K.A. Womack K.b. L.H. Lacritz 张殿增 University of Texas Southwestern Medical Center 5323 Harry Hines Blvd. Dallas TX 75390-8846 United States Dr.

Objective: To determine the clinical utility of the Frontal Assessment battery (FAb), a short test of frontal lobe functions, in differentiating frontotemporal lobar degeneration (FTLD)from Alzheimer disease (AD). Methods: FAb total scores and subscores for 23 subjects with FTLD and 31 subjects with AD were compared for sensitivity, specificity, and positive predictive value. Concurrent validity of the FAb with the Mini-Mental State Examination (MMSE) and other scales was also assessed. results: The FAb did not have positive predictive value for FTLD. Total FAb scores did not differ.b.tween the FTLD and AD groups. However, three subtests of the FAb (mental flexibility, motor programming, and environmental autonomy)demonstrated significant differences between the two groups. Total FAb scores correlated with scores on the MMSE,amore general test of cognition. Conclusion: The Frontal Assessment battery did not discriminate subjects with frontotemporal lobar degeneration from those with Alzheimer disease, though certain subtests may be helpful in differential diagnosis.

关键词：额颞叶变性 FAb 预测价值 AD

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偏头痛与心血管疾病

美国医学会杂志（中文版） 2007年第6期26卷 356-357页

作者： richard b. lipton Marcelo E. bigal 陈夏欢（译）冯雪茹（译）刘梅林（校） Departments of Epidemiology and Population Health Departments of Epidemiology and Population Neurology Albert Einstein College of Medicine and the Montefiore Headache Center 不详

偏头痛和缺血性血管事件的相关性争论已久。如今，有先兆偏头痛已被确认为缺血性卒中的危险因素（特别是对女性患者）。偏头痛与缺血性心脏病的关系目前仍不很清楚。虽然有几篇研究证实，偏头痛，特别是有先兆偏头痛与心绞痛相关，但是... 详细信息

偏头痛和缺血性血管事件的相关性争论已久。如今，有先兆偏头痛已被确认为缺血性卒中的危险因素（特别是对女性患者）。偏头痛与缺血性心脏病的关系目前仍不很清楚。虽然有几篇研究证实，偏头痛，特别是有先兆偏头痛与心绞痛相关，但是并无确凿的证据证明偏头痛与不良的心血管结局（如心肌梗死和血运重建）相关。

关键词：心血管疾病偏头痛缺血性卒中缺血性心脏病女性患者危险因素血运重建心肌梗死