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MRI阴性而PET阳性的颞叶癫痫:一组可应用手术治疗的症候群

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世界核心医学期刊文摘（神经病学分册） 2005年第3期1卷 32-32页

作者： Carne R.P. O'Brien T.j. Kilpatrick C.j. 杜芳 Department of Clinical Neurosciences Geelong Hospital Kardin ia House Bellerine St Geelong Vic. 3220 Australia Dr.

Most patients with non lesional temporal lobe epilepsy (NL TLE) will have th e findings of hippocampal sclerosis (HS) on a high resolution MRI. However, a si gnificant minority of patients with NLTLE and electroclinically well lateral i zed temporal lobe seizures have no evidence of HS on MRI. Many of these patients have concordant hypometabolism on fluorodeoxyglucose PET([ 18F]FDG PET). Th e pathophysiological basis of this latter group remains uncertain. We aimed to det ermine whether NLTLE without HS on MRI represents a variant of or a different cl inicopathological syndrome from that of NLTLE with HS on MRI. The clinical, EEG, [18F]FDG PET, histopathological and surgical outcomes of 30 consecutive NLTL E patients with well lateralized EEG but without HS on MRI (HS ve TLE) were comp ared with 30 consecutive age and sexmatched NLTLE patients with well lateraliz ed EEG with HS on MRI (HS+ve TLE). Both the HS+ve TLE group and the HS ve TLE patients had a high degree of [18F] FDG PET concordant lateralization (26 o ut of 30 HS ve TLE versus 27 out of 27 HS+ve TLE). HS ve TLE patients had more widespread hypometabolism on [18F]FDG PET by blinded visual analysis [odds r ati o (OR = +∞(2.51-+∞), P = 0.001]. The HS ve TLE group less frequently had a history of febrile convulsions [OR = 0.077 (0.002-0.512), P = 0.002], more c om monly had a delta rhythm at ictal onset [OR = 3.67 (0.97-20.47), P = 0.057], an d less frequently had histopathological evidence of HS [OR = 0 (0-0.85), P -0 . 031]. There was no significant difference in surgical outcome despite half of t h ose without HS having a hippocampal sparing procedure. Based on the findings ou tlined, HS ve PET positive TLE may be a surgically remediable syndrome distinc t from HS+ve TLE, with a pathophysiological basis that primarily involves later al temporal neocortical rather than mesial temporal structures.

关键词：颞叶癫痫 MRI PET 海马硬化异常放电 δ节律病理生理机制热惊厥皮质区临床病理学

新生儿重症监护病房中氟康唑预防性给药对侵袭性念珠菌病发病和预后的影响

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世界核心医学期刊文摘（儿科学分册） 2006年第1期2卷 26-26页

作者： Healy C.M. Baker C.j. Zaccaria E. Campbell j.R. 朱新菊 Department of Pediatrics Section of Infectious Diseases Baylor College of Medicine One Bay lor Plaza Houston TX 77030 United States Dr.

Obj.ctives: We assessed the impact of intravenous fluconazole prophylaxis (FP) in extremely low birthweight (ELBW[<1000 g]) infants on the incidence of and ou tcome from invasive candidiasis (IC) in all infants admitt... 详细信息

Obj.ctives: We assessed the impact of intravenous fluconazole prophylaxis (FP) in extremely low birthweight (ELBW[ou tcome from invasive candidiasis (IC) in all infants admitted to a neonatal inten sive care unit (NICU). Study design: Beginning April 1, 2002, FP was given to EL BW infants aged our NICU in spite of FP and shifted to bigger,m ore mature infants who had a better outcome.

关键词：预防性给药侵袭性念珠菌极低出生体重儿静脉内注射研究设计成熟度

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拉坦前列素可导致睫毛下垂

世界核心医学期刊文摘（眼科学分册） 2005年第9期1卷 24-24页

作者： Casson R.j. Selva D. 张鹏 Glaucoma Unit Department of Ophthalmology Royal Adelaide Hospital North Terrace Adelaide SA 5000 Australia

PURPOSE: To report a case of lash ptosis caused by latanoprost. DESIGN: Observational case report. METHODS: Retrospective chart review. RESULTS: A 61-year-old, ocular hypertensive man who was using latanoprost ou presented with trichomegaly and bilateral lash ptosis. The lash ptosis had not resolved 6 months after stopping latanoprost, and anterior lamellar repositions were performed. At last follow-up, 8 months after surgery, the lids were in a normal position, but the trichomegaly had reduced only slightly. CONCLUSIONS: Lash ptosis should be considered as a possible complication of latanoprost therapy.

关键词：拉坦睑板高眼压位置正常位置调整观察性性图

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决定正常核型水囊瘤胎儿结局的相关因素

世界核心医学期刊文摘（妇产科学分册） 2005年第5期1卷 15-15页

作者： Tanriverdi H.A Ertan A.K Hendrik H.j. 白符 Dept. of Obstetrics and Gynecology Karaelmas University Medical School Kozlu 67600 Zonguld ak Turkey

Obj.ctive: To determine the associated diagnostic findings which are linked wi th adverse fetal outcome in nuchal cystic hygroma. Study design: Based on a seri es of 32 cases, we determined the sonographic morphology of the hygroma, associa ted structural anomalies, karyotypes and autopsy findings. Intrauterine fetal de ath, spontaneous abortion and abnormal karyotypes were assigned as adverse outco me parameters. Results: The mean gestational age at diagnosis was 14.4 weeks (ra nge 10-21). There were 18 nonseptated and 14 septated hygromas. Besides hygroma , associated sonographic detectable structural anomalies were observed in 17 cas es (53.1%). The greatest number of associated sonographic anomalies were hydrop s (31.3%), generalised skin oedema (6.3%) and pterygium colli (6.3%).Cytogene tic analysis revealed an abnormal karyotype in 13 of 26 (50%) invasive procedur es. Turner syndrome and Trisomy 18 (both 15.4%) were the most frequent cytogene tic abnormalities. Autopsy was performed in 24 cases and 16 cases (66.7%) had a n associated autopsy finding to hygroma colli. The most frequent associated auto psy findings were limb and craniofacial anomalies (both 25%). Only 3 (9.4%) mo thers gave birth to healthy newborns. The overall fetal adverse outcome rate was 68.8%(22 cases). Conclusions: Fetuses with NCH are at high risk for adverse ou tcome and detailed prenatal diagnosis including invasive procedures should be of fered. According to the presented autopsy findings, to determine fetal outcome i n NCH cases with normal karyotypes, detailed sonography should be concentrated b eside the exclusion of fetal heart defects and existence of hydrops fetalis, on the skeletal, urogenital and craniofacial anomalies, as these might cause severe morbidity.

关键词：水囊瘤正常核型面部畸形皮肤水肿产前诊断先天性蹼颈异常染色体核型自然流产三体胎死宫内

儿童接受心脏移植术后的淋巴增生性疾病:一项多中心研究

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世界核心医学期刊文摘（儿科学分册） 2006年第5期2卷 4-4页

作者： Webber S.A. Naftel D.C. Fricker F.j. 张振 Departments of P ediatrics Children's Hospital University of Pittsburgh Pittsburgh PA 15213 United States.Dr

Background: Post-transplant lymphoproliferative disorders (PTLD) are an impor tant cause of morbidity and mortality after organ transplantation. We sought to better define the prevalence, pathology, current therapeutic approaches, and out comes of PTLD in a large group of children who had received heart transplants. M ethods: We assessed data on patients followed up at 19 centres in the Pediatric Heart Transplant Study (PHTS) from 1993 to 2002. Probability of freedom from PTL D was assessed along with details of presentation, pathology, treatment, and out comes. Risk factors for survival and event-free survival were investigated. Findings: Of 1184 primary transplant recipients, 56 (5%) developed PTLD. Probabili ty of freedom from PTLD was 98%at 1 year, 94%at 3 years, and 92%at 5 years. M ean time to PTLD was 23.8 months. Most common sites of disease were gastrointest inal tract (n=22, 39%) and respiratory system (n=14, 25%). Histology was polym orphic in 35 (65%) and monomorphic in 19 (35%). 47 of 48 cases were of B-cell origin, 39 of 45 (87%) were Epstein-Barr virus positive. Probability of survi val was 75%at 1 year, 68%at 3 years, and 67%at 5 years after diagnosis. Death from graft loss was as frequent as death from PTLD. Interpretation: About 5%of paediatric heart-transplant recipients develop PTLD, almost always of B-cell lineage and driven by Epstein-Barr virus. Although many achieve satisfactory ou tcomes, mortality remains substantial with death due to progressive disease and allograft loss. Advances in management should focus on strategies to protect the allograft as well as improved therapies for PTLD.

关键词：淋巴增生性疾病心脏移植术后多中心研究儿童术后患者病理学改变器官移植研究对象临床结局治疗方法

感觉运动性卒中早期恢复期内BOLD应答的变化

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世界核心医学期刊文摘（神经病学分册） 2005年第3期1卷 51-51页

作者： Binkofski F. Seitz R.j. 李一明 Department of Neurology Univ. Hospital Schleswig Holstein Campus Lübeck Germany Dr.

Background: The BOLD signal in functional MRI (fMRI) is closely related to neu ral activity. Obj.ctive: To investigate if this relationship is disrupted after ischemic stroke. Methods: BOLD activity during tactile exploration of obj.cts wa s measured with fMRI at 1 week (subacute), 2 to 4 weeks (early chronic), and aft er 1 month (chronic) after the first completed brain infarction affecting the se nsorimotor cortex in eight patients. Functional integrity of the motor cortical output system was assessed with transcranial magnetic stimulation (TMS). Results : Early after infarction the BOLD response occurred in the adj.cent cortical vi cinity related to finger movements of the affected hand. However, during the ear ly chronic stage there was a transient lack of this activation despite clinical improvement of hand function and preserved motor evoked potentials. The BOLD act ivity reappeared after further improvement in the chronic stage. Conclusions: ou r findings suggest a transient hemodynamic electrical decoupling in the post i schemic cerebral cortex during the early phase of spontaneous clinical recovery.

关键词：感觉运动性卒中 BOLD 缺血性卒中经颅磁刺激亚急性期运动诱发电位感觉运动皮质慢性期功能磁共振电耦联

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基于Ns的自适应IP流分类器的研究

计算机工程与应用 2001年第22期37卷 89-91,118页

作者：王思兵姜宁康李毓麟上海交通大学光纤区域通信网国家重点实验室上海200030

基于IP的Internet取得了巨大的成功,也面临着新的挑战。IP和ATM结合技术是解决Internet存在问题的方法之一,文中讨论了三种IP技术的特点,分析了实现IP交换的几项关键技术,并给出了解决方案。在此基础上,构造了一个用来分析IP交换性能的I... 详细信息

基于IP的Internet取得了巨大的成功,也面临着新的挑战。IP和ATM结合技术是解决Internet存在问题的方法之一,文中讨论了三种IP技术的特点,分析了实现IP交换的几项关键技术,并给出了解决方案。在此基础上,构造了一个用来分析IP交换性能的IP交换流分类器的系统模型,最后介绍了开放式、事件驱动的网络仿真平台NS(NetworkSimulator),并利用NS来实现文中提出的自适应流分类器AFC的结构。

关键词： Internet 自适应IP流分类器 ATM 路由器