Electroencephalographic findings in Tanzanian epileptic patients

Electroencephalogram (EEG) of 524 Tanzanian epileptic patients seen between 1985 and 1987 were reviewed. Over two thirds were young patients between the ages of five and thirty. Four hundred and fifty (86%) had abnormal records. Eighty nine per cent of abnormal records had focal abnormality and 11% had centrencephalic abnormality. Grand mal seizures did not imply centrencephalic abnormality, only 13% had such abnormality. Petit mal seizures are rare, over one third of these had temporal focal abnormality. Partial seizures were associated highly with focal abnormality. However, complex partial seizures did not imply temporal focal abnormality. Implications of EEG findings to correlation with epileptic seizures is discussed.     

Ehlers-Danlos syndrome and type III collagen abnormalities: a variable clinical spectrum

Ehlers Danlos syndrome (EDS) comprises ten types. EDS IV is the most severe type because of its often lethal complications, such as arterial rupture. EDS IV is caused by an abnormality of collagen type III as a result of mutations in the corresponding gene COL3A1. A collagen type III abnormality is also seen in patients with EDS without the classical severe EDS IV phenotype. We report on 11 patients with type III collagen abnormality and normal collagen V in whom clinically EDS II, III, and IV were diagnosed. There is no correlation between the type of collagen III anomaly and the clinical phenotype. It is concluded that type III collagen abnormality may lead to a phenotypic spectrum and that it does not predict the severity and course of the disease.     

Apical filling abnormality in patients with heart failure assessed with contrast echocardiography using venous injection of Albunex

Contrast echocardiography by venous injection of Albunex was used to visualize apical filling abnormality in patients with heart failure. 1. Contrast echocardiography was serially performed in 24 patients with acute anterior myocardial infarction. Wall motion of the infarct region was better at any stage in patients without apical filling abnormality than in patients with that. Improvement of filling abnormality was observed prior to that of wall motion abnormality. 2. Influence of tachycardia was assessed on apical filling in 20 patients with old myocardial infarction during rapid atrial pacing. Stress contrast echocardiography evidenced that tachycardia deteriorates apical filling abnormality in patients with chronic heart failure. 3. The effect of amrinone on apical filling was assessed in 60 patients with chronic anterior myocardial infarction. Apical filling abnormality improved in 46% of patients after amrinone infusion. The improvement of apical filling abnormality was closely related to the reduction of preload and improvement of asynergy in the infarct area after amrinone. Both adjunctive therapy and anticoagulant therapy should be considered if apical filling abnormalities are observed by contrast echocardiography.     

Model-free reconstruction of three-dimensional myocardial strain from planar tagged MR images

A technique is presented for reconstructing a three-dimensional myocardial strain map from a set of parallel-tagged MR images. Radial strains were reconstructed from in vivo data from an anesthetized dog with values between .05 and .1 with a precision of +/- .003 for a tag detection accuracy of .1 mm and a tag spacing of 2.5 mm. The reconstruction spatial resolution was demonstrated by reconstructing a localized displacement abnormality. In the circumferential direction, the abnormality that resulted in 50% displacement attenuation had a full width at half maximum of 5.4 +/- .4 mm (mean +/- SD). Graphs are presented showing the relationship between the size of an abnormality and the ability of the method to reconstruct that abnormality. The combination of high resolution parallel-tagged MR images and the model-free, coordinate system-free strain reconstruction technique presented in this paper is capable of producing accurate, high resolution strain maps of the myocardium.     

天钢2 000 m3高炉炉况失常及处理

针对炉况失常的现象进行了原因分析。焦炭质量差、持续低炉温、冷却强度过大是造成本次炉况失常的主要原因。采取了处理措施并总结了操作中应注意的问题。     

Impaired temporal resolution of vision after acute retrobulbar neuritis

Following retrobulbar neuritis patients need a greater interval between two flashes of light in order to see them as double. The abnormality is large and easily detectable; the values lie well outside the normal 99 per cent tolerance limits. The abnormality sometimes occurs in localized retinal areas but can cover the whole visual field. The abnormality is a persistent one, remaining up to five years after visual acuity has returned to normal. It can occur in the absence of optic atrophy and with normal visual fields. There is also a delay in visual perception following retrobulbar neuritis but when this and double flash discrimination are both measured at the same retinal sites, the areas of abnormality do not correlate for the two tests. This indicates that the two tests monitor different aspects of visual damage. Double flash threshold can be a more sensitive indication of visual damage due to demyelination than conventional clinical tests including critical flicker fusion frequency. It provides an absolute measurement of local damage in the visual field and has advantages over the recording of perceptual delay and of evoked potentials.     

Parents'' evaluations of wheezing in their children with asthma

Two cases of Behcet's disease associated with myelodysplastic syndrome are described. Both patients showed a chromosomal abnormality, trisomy 8. Based on the laboratory findings in our patients and a careful review of the literature of similar cases, the association of the chromosomal abnormality with the pathogenesis of Behcet's disease is suggested.     

The efficacy of hysteroscopy: a comparison of women presenting with infertility versus other gynaecological symptoms

The aim of this study was to compare the relative efficacy of hysteroscopy as a management tool in the routine initial assessment of women presenting for investigation of infertility with women presenting for investigation of other general gynaecological symptoms for which it is routinely performed. The results of 400 consecutive completed hysteroscopies performed during the primary investigation of infertility are compared with 400 consecutive completed hysteroscopies undertaken in the investigation of women with other gynaecological symptoms. Abnormalities were detected in 12.3% of the 800 hysteroscopies. Significantly less of the infertility group demonstrated abnormality (8.8%) compared to the general gynaecological group (15.8%) (p = 0.0034). There was no difference in the detection rate between primary and secondary infertility. In patients undergoing the procedure for infertility, the results of the hysteroscopy led to an alteration in management in 5.8% of the entire group and in 65.7% of those in whom an abnormality was detected. In patients undergoing the procedure for general gynaecological symptoms, the results of the hysteroscopy led to an alteration in management in 14.5% of the total group and in 97.2% of those in whom an abnormality was detected (p < 0.0001). Structural abnormality correlated with the presence of histological abnormality in 97.2% of cases. In infertile women, the use of hysteroscopy is supported as part of a comprehensive assessment of female reproductive anatomy.     

Prevalence of myocardial ischemia as depicted by regional wall motion abnormality in blacks

Coronary artery disease with subsequent myocardial ischemia is a common cause of morbidity and mortality in the United States, and data are scarce on the prevalence of the disease in blacks. Regional wall motion abnormality correlates either directly or indirectly with myocardial ischemia. This study examines the two-dimensional (2-D) echocardiography of patients > or = 45 years for men and > or = 55 years at Metropolitan Nashville General Hospital, Nashville, Tennessee. A total of 601 2-D echocardiographic studies were performed on patients who presented with symptoms and signs of cardiovascular disease. Of these, 377 (62.7%) met the age criteria and formed the study group; 92 were excluded for various reasons, leaving 285 (75%) in the analysis group. A total of 80 (28.1%) patients had regional wall motion abnormality while 205 (71.9%) did not. On analysis of the 80 patients with regional wall motion abnormality, the segment of the heart commonly affected was the septal area, although more than one segment of the myocardium was affected in all of the patients. A total of 36 (45%) patients had normal left ventricular size. In relation to race, blacks had a higher prevalence of regional wall motion abnormality compared with whites (29.2% versus 26.2%, respectively), but the difference was not statistically significant. These prevalence rates indicate the importance of looking for this abnormality during echocardiographic evaluation of a patient. The presence of regional wall motion abnormality on 2-D echocardiography in the presence of other cardiovascular risk factors necessitates further investigation and management to minimize later complications of coronary artery disease.     

The determination of INR in stored whole blood

Portal venous aneurysm is an unusual vascular abnormality. We present this entity with magnetic resonance imaging (MRI) findings showing characteristic flow abnormality in two patients. Ultrasound examination revealed hyperechoic lobulated masses in the portal vein and the duplex Doppler study confirmed the venous flow patterns of low resistance within the lesion. The literature regarding this entity and the potential role of MRI are briefly discussed.     

Diaphragmatic paralysis

Ankle inversion injuries are the most common injury in sport and yet treatment is controversial. One result is chronic ankle instability, an injury for which criteria for surgical intervention are unclear. This prospective study of 14 patients showed that a large proportion of patients had no detectable abnormality on preoperative investigation, but were subsequently shown to have an abnormality under general anaesthesia. This suggests that a good history of chronic instability is more sensitive an indicator than conventional investigations. Stress views under anaesthesia may confirm the problem.     

Hydrodynamics of syringomyelia

Abnormality of CSF hydrodynamics is an important factor of the pathogenesis of syringomyelia. Recent development of cine-MRI visualized real time CSF movement in the syrinx or subarachnoid space. In the present study, twenty cases of syringomyelia associated with Chiari I malformation, 10 cases of syringomyelia associated with spina bifida aperta, and 10 cases of syringomyelia associated with spina bifida occulta were studied with MRI and cine-MRI. The result demonstrated that hydrodynamics of these three groups were different to each other. Chiari I malformation showed CSF hydrodynamic abnormality at the foramen magnum and marked flow void in the syrinx. On the other hand, myelomeningocele showed hydrocephalus and less prominent flow void in the syrinx. Spinal lipoma which is the majority of spina bifida occulta showed no abnormality of CSF hydrodynamics. In conclusion, the selection of treatments should be individualized depending on the hydrodynamical abnormality of each patient.     

Evoked potentials and head injury. 1. Rating of evoked potential abnormality

This paper describes a method for rating the degree of abnormality of auditory, visual and somatosensory evoked potential patterns in head injury (HI) patients. Criteria for judging degree of EP abnormality are presented that allow assessment of the extent and severity of subcortical and cortical dysfunction associated with traumatic brain damage. Interrater reliability data based upon blind ratings of normal and HI patients are presented and shown to be highly significant. Tables of normative values of peak latencies and amplitudes are given and illustrations of EP patterns of different degrees of abnormality are presented.     

Emergent endoluminal repair of delayed abdominal aortic rupture after blunt trauma

A 72-year-old man with increased monocytes and eosinophils in the bone marrow was found to have an isochromosome, i(14q), as the sole abnormality on bone-marrow cytogenetics. Follow-up over 12 months with repeat cytogenetic testing of bone marrow specimens on three further occasions showed an additional abnormality consisting of an apparently balanced translocation, t(6;21)(p21.1; q22). This abnormality, together with other features, indicated disease progression. A review of seven reported cases of i(14q) revealed limited follow-up information.     

Lateralization of temporal lobe epilepsy based on regional metabolic abnormalities in proton magnetic resonance spectroscopic images

Magnetic resonance spectroscopic imaging (MRSI) is capable of determining the spatial distribution in vivo of cerebral metabolites, including N-acetylaspartate (NAA), a compound found only in neurons. We used this technique in 10 patients with temporal lobe epilepsy (TLE) to determine the location of maximal neuronal/axonal loss or damage and to evaluate the potential of MRSI for presurgical lateralization. Asymmetry of the relative resonance intensity of NAA to creatine was determined for mid and posterior regions of the temporal lobes defined anatomically and also for "metabolic lesions" defined as the regions of maximal abnormality on MRSI. MRSI revealed decreased relative signal intensity in at least one temporal lobe of all patients. Two patients had a widespread reduction in NAA in both temporal lobes. The region of maximal abnormality was usually in the posterior temporal lobe but sometimes in the mid temporal lobe. The side of lowest NAA was ipsilateral to the clinical electroencephalographic lateralization in all patients. Lateralization based on NAA to creatine correlated with the atrophy of amygdala and hippocampus in 8 patients who showed this on magnetic resonance imaging volumetric measurements. MRSI can demonstrate regional neuronal loss or damage that correlates with clinical electroencephalographic and structural lateralization in temporal lobe epilepsy. The ability to identify a region of maximal metabolic abnormality on spectroscopic images may confer greater sensitivity than that available from single voxel methods. The maximal metabolic abnormality may not be located in a voxel defined a priori, and based on anatomical considerations, without knowledge of the distribution of the metabolic abnormality.     

Trisomy 21 in childhood acute lymphoblastic leukemia: a Pediatric Oncology Group study (8602)

Of 1,036 children with newly diagnosed non-T, non-B acute lymphoblastic leukemia (ALL) and a demonstrated cytogenetic abnormality treated on the frontline Pediatric Oncology Group (POG) therapeutic trial 8602, there were 33 patients with trisomy 21 as the sole abnormality. Of these 33, 14 had Down syndrome (DS). Although the non-DS (NDS) trisomy 21 cases tended to be older than the DS cases, there were no other significant differences in clinicobiologic features nor in treatment outcomes between the DS and NDS groups, nor between the entire trisomy 21 group and the other chromosome abnormality group. Among NDS patients with +21 and one additional abnormality, +X, +16, -20, and structural abnormalities involving 6q or 12p were common findings. Kaplan-Meier event-free survival (EFS) curves showed a 4-year EFS of 80% (SE, 12%) in NDS trisomy 21 cases, 71% (SE, 22%) in DS cases with trisomy 21 as the sole abnormality, and 69% (SE, 2%) in cases with other chromosome abnormalities. Trisomy 21 as a sole acquired abnormality in NDS patients suggests a good prognosis.     

Biological markers of Alzheimer''s disease

A 49-year-old woman presented with splenic lymphoma with villous lymphocytes (SLVL) that showed a clonal abnormality of del(7)(q22q32) in addition to inv(10)(p13q23), the latter being a previously undescribed abnormality in chronic lymphoproliferative disorders. A review of the literature on cytogenetic abnormalities of SLVL indicates that del(7q) is strongly associated with SLVL and may be important in the pathogenesis of this disorder.     

Smooth pursuit eye movement deficits after pontine nuclei lesions in humans

Eye movements were recorded electroculographically in four patients with basal pontine lesions, demonstrated by MRI. The most prominent eye movement abnormality observed was mild to severe impairment of smooth pursuit and optokinetic nystagmus, mainly ipsilateral to the lesion. This abnormality is thought to result from damage to the pontine nuclei, which form a crucial relay between the cerebral cortex and the cerebellum controlling smooth pursuit. Abnormalities of saccades and the vestibulo-ocular reflex in one patient are also discussed.     

火山岩区土壤地球化学测量数据的处理与找矿——以珲春柳树河子金铜矿区为例

以火山-次火山岩发育为特征的柳树河子金铜矿(化)区,受晚侏罗-早白垩世火山机构控制.土壤地球化学测量结果表明,Au元素异常与主火山口周围呈环形分布的寄生火山口中次火山岩株(闪长玢岩)分布位置相吻合,Cu元素异常与火山机构中心相酸性次火山岩(花岗斑岩)小岩株空间位置相吻合.结合矿区地质背景分析并进一步对土壤测量数据处理,确定出本区金矿主要控矿构造主要为北西向,北东向和南北向次之,受火山构造和闪长玢岩小岩株联合控制;铜矿主要受花岗斑岩岩株控制.     

The abnormal hepatic scan of chronic liver disease: its relationship to hepatic hemodynamics and colloid extraction

To help explain the characteristic hepatic scan pattern of chronic liver disease, the degree of scan abnormality (scan score, SS) after administration of technetium-99m sulfur colloid (Tc) was compared with data obtained at hepatic vein catheterization in 28 patients. Although SS showed a correlation with wedged hepatic vein pressure (r = +0.491), the scan abnormality was not directly due to portal hypertension because it remained unchanged when the latter was relieved by portacaval shunt. Also, the scan abnormality was found to be unrelated to a low hepatic blood flow. Scan abnormality was not attributable primarily to hyperactivity of the reticuloendothelial (RE) cells of the spleen and bone marrow since fractional clearance (K) of Tc from the blood was decreased rather than increased in patients with abnormal scans. SS was inversely correlated with K or Tc (r = -0.575) and with hepatic extraction efficiency for Tc (r = -0.673), showing that the basic abnormality was poor extraction of the colloid by the RE cells of the liver with a resultant increase in the amount available for extrahepatic localization. Indirect evidence suggests that this poor extraction of colloid is due to intrahepatic shunts bypassing hepatic RE cells.