妥泰治疗小儿癫(癎)80例疗效观察

目的 观察妥泰单药治疗小儿癫(癎)的疗效.方法 将入选的80例癫(癎)患者均采用妥泰单药治疗,入选病例未服用过其他抗癫(癎)药.从0.5～1.0 mg/(kg·d)开始,分2次口服,每周增加0.5～1.0 mg/(kg·d),经8周增至剂量4～8 mg/(kg·d),维持该剂量12周.结果 完全控制23例(28.75%...     

妥泰治疗小儿癫(癎)80例疗效观察

目的 观察妥泰单药治疗小儿癫(癎)的疗效.方法 将入选的80例癫(癎)患者均采用妥泰单药治疗,入选病例未服用过其他抗癫(癎)药.从0.5～1.0 mg/(kg·d)开始,分2次口服,每周增加0.5～1.0 mg/(kg·d),经8周增至剂量4～8 mg/(kg·d),维持该剂量12周.结果 完全控制23例(28.75%),显效21例(26.25%),有效18例(22.50%),无效18例(22.50%),总有效率(77.50%).结论 妥泰既不诱导肝酶也不抑制肝酶,无须监测血浓度,使用较方便,用于治疗小儿癫(癎)的成本也不高,故可推广使用.     

托吡酯长期治疗儿童癫(癎)部分性发作疗效及耐受性的观察

目的观察托吡酯长期治疗儿童癫(癎)部分性发作的疗效、耐受性及安全性.方法对86例癫(癎)部分性发作的患儿给予托吡酯加用或单药治疗,起始剂量为0.5～1.0 mg/(kg·d),分2次口服,每周增加0.5～1.0 mg/(kg·d),经过8周加量期及18个月稳定期,观察其疗效、耐受性及安全性.结果 86例患儿完成加量期后,总有效率为61.6%,控制率为37.2%.稳定期6、12及18个月时总有效率分别为68.6%、81.9%及86.4%,控制率分别为46.5%、59.0%及60.5%,稳定期12及18个月时总有效率及控制率与加量期比较差异有显著性(均P<0.05).不良反应多发生在治疗初期,为一过性轻～中度嗜睡、厌食等.在稳定期18个月时仍有78例(90.7%)坚持服用托吡酯.结论托吡酯对儿童癫(癎)部分性发作的长期治疗,具有较高的疗效及较好的安全性与耐受性.     

奥卡西平治疗癫(癎)部分性发作的疗效观察

目的:观察奥卡西平治疗癫癎部分性发作的疗效.方法:51例部分性发作的癫癎患者采用奥卡西平治疗.成年患者起始剂量300mg/d,根据病情逐渐加量,3d后增至基本维持量(600mg/d),仍有发作者继续加量,2周后达最佳效果或可耐受的最高剂量(1800mg/d);儿童患者起始剂量8-10mg/(kg·d),根据病情每周加1次剂量,每次加量不超过10 mg/(kg·d),直至维持剂量30-40mg/(kg·d).观察治疗后癫癎发作情况及药物不良反应.结果:奥卡西平治疗5个月后,本组患者总有效率为74%,完全控制率为30%.用药1个月内,本组7例患者出现不良反应,1例因全身皮疹停用奥卡西平.结论:奥卡西平治疗癫癎部分性发作的疗效较好,但有时可产生较严重不良反应,临床应用须谨慎.     

托吡酯治疗癫癎的长期疗效观察

目的观察托吡酯治疗不同类型癫癎的长期疗效及安全性.方法采用开放性试验的方法,给予115例不同类型癫癎患者托吡酯单药或添加治疗,6个月后进行疗效评定,1年和2年时计算控制率和托吡酯保留率,记录不良反应.结果 (1) 6个月时总有效率单药治疗组为83.9%,添加治疗组为66.1%,对各型癫癎均有一定疗效,各组间发作控制率和总有效率比较差异无显著性;(2)稳定期儿童组有效剂量为(105.72±48.28) mg/d,成人组为(176.36±62.81) mg/d;(3)控制率1年为40.0%,2年为28.7%;保留率1年为67.8%,2年为46.1%;(4)34例(29.6%)出现不良反应,为轻、中度的中枢神经系统症状以及厌食和体质量减轻.结论托吡酯是较好的广谱抗癫癎药物,长期应用仍有较好的疗效和安全性.     

奥卡西平治疗儿童部分发作性癫80例临床分析

目的观察国产奥卡西平(OXC)治疗儿童部分发作性癫的疗效、安全性和耐受性。方法用国产奥卡西平单药治疗80例部分发作性癫患儿,分析治疗后1、2、3、6、9、12个月的疗效和不良反应。奥卡西平起始剂量5~10 mg/(kg·d),最大剂量30~40 mg/(kg.d),维持剂量中位值20 mg/(kg·d),bid。结果本组总有效率为87.50%,服药12个月时累积控制率为73.75%,有5例因严重不良反应而调用其他药物,余75例均能耐受。结论国产奥卡西平为治疗儿童部分性发作性癫相对理想的药物选择。     

托吡酯长期治疗儿童癫痫部分性发作疗效及耐受性的观察

目的观察托吡酯长期治疗儿童癫(癎)部分性发作的疗效、耐受性及安全性.方法对86例癫(癎)部分性发作的患儿给予托吡酯加用或单药治疗,起始剂量为0.5～1.0 mg/(kg·d),分2次口服,每周增加0.5～1.0 mg/(kg·d),经过8周加量期及18个月稳定期,观察其疗效、耐受性及安全性.结果 86例患儿完成加量期后,总有效率为61.6%,控制率为37.2%.稳定期6、12及18个月时总有效率分别为68.6%、81.9%及86.4%,控制率分别为46.5%、59.0%及60.5%,稳定期12及18个月时总有效率及控制率与加量期比较差异有显著性(均P<0.05).不良反应多发生在治疗初期,为一过性轻～中度嗜睡、厌食等.在稳定期18个月时仍有78例(90.7%)坚持服用托吡酯.结论托吡酯对儿童癫(癎)部分性发作的长期治疗,具有较高的疗效及较好的安全性与耐受性.     

单用不同剂量托吡酯与奥卡西平治疗儿科癫(癎)的疗效比较

目的 观察单用不同剂量托吡酯及奥卡西平治疗儿科癫患儿的临床疗效和不良反应.探讨单用托吡酯更安全、更有效的给药方法.方法 儿科癫患儿120例,分为奥卡西平组31例,服用奥卡西平从8～10mg/(kg·d)开始,再逐渐增量到10～30mg/(kg·d),2次/d服用;单用托吡酯组,89例患儿按服药剂量不同又分为低剂量组47例托1组从0.625mg/(kg·d)开始增加至4mg/(kg·d)为止;高剂量组42例托2组从1.5mg/(kg·d)开始,逐增至8mg/(kg·d)为止.结果 托1组总有效率81%,托2组总有效率74%;奥卡西平组总有效率77%,3组比较无显著差异(P＞0.05).托2组不良反应发生率(57%)高于托1组(34%)(P＜0.05).托吡酯组主要不良反应为胃纳差、头痛、感觉异常、嗜睡和体质量减轻.结论 单用较小剂量托吡酯治疗儿科癫发作,疗效好,不良反应少.     

丙种球蛋白佐治小儿难治性癫痫疗效分析

目的 探讨丙种球蛋白佐治小儿难治性癫(癎)的疗效.方法 对30例难治性癫(癎)在原用抗癫(癎)药物(AEDs)不变的基础上,加用丙种球蛋白0.4mg/(kg·d),3～5d辅助治疗.主要观察治疗前后发作频率的改变情况,不良反应及其对原用抗癫(癎)药物血药浓度的影响.结果 显效8例,有效10例,无效12例.不良反应较少 .结论 加用丙种球蛋白可提高小儿难治性癫(癎)的疗效,且不影响其他抗癫(癎)药物的血药浓度.     

丙种球蛋白佐治小儿难治性癫(癎)疗效分析

目的 探讨丙种球蛋白佐治小儿难治性癫(癎)的疗效.方法 对30例难治性癫(癎)在原用抗癫(癎)药物(AEDs)不变的基础上,加用丙种球蛋白0.4mg/(kg·d),3～5d辅助治疗.主要观察治疗前后发作频率的改变情况,不良反应及其对原用抗癫(癎)药物血药浓度的影响.结果 显效8例,有效10例,无效12例.不良反应较少 .结论 加用丙种球蛋白可提高小儿难治性癫(癎)的疗效,且不影响其他抗癫(癎)药物的血药浓度.     

Denervation study of synapses of organ of corti of old world monkeys

Fine structural characteristics of synapses in the spiral organ of Corti were examined, with reference to differences between inner and outer haircell systems, and to location of neurons of origin of efferent axons. Surgical interruption of crossed olivocochlear bundle, of vestibular nerve, of facial nerve, and excision of superior cervical ganglia were used to determine the pathways of efferent axons. Interruption of the vestibular nerve near the brainstem results in degeneration of all efferent terminals on outer hair cells. Mid-line lesions at, and caudal to, the facial colliculus result in degeneration of about half of these efferent terminals. Efferent synaptic bulbs to the inner hair-cell system are small, of the order of one micron, and form type 2 junctions with afferent dendrites. They tend to have more large dense-core vesicles (about 80 nm) than the large efferent terminals of the outer hair-cell system, and appear to be the terminals of axons in the habenula perforata, which exhibit varicosities laden with large dense core vesicles. The varicosities are unaffected by excision of the superior cervical ganglia. So far as our material can reveal, it appears that the varicosities in the habenula perforata do not survive vestibular root interruption, nor do the efferent processes in the internal spiral bundle or at the base of inner hair cells. Most interestingly, the afferent processes of the inner hair-cell system, as identified for example by their relation to pre-synaptic bodies in the inner hair cells, are subject to a trans-synaptic reaction after severance of the vestibular root. They undergo a dramatic cytological transformation, characterized by increase of volume, engorgement with microtubules, microfilaments, microvesicles of various sizes, and clusters of lysosomes. Thus, both the efferent and afferent terminals of the inner hair-cell system show marked cytological differences from the corresponding terminals of the outer hair cell system.     

Summary of legislation of 1935 of interest to the department of Mental Hygiene

Psychiatric Quarterly -     

Summary of legislation of 1941 of interest to the Department of Mental Hygiene

Psychiatric Quarterly -     

Asymmetry of on- and off-pathways of blue-sensitive cones of the retina of macaques

Macaque retinal ganglion cells whose receptive-field center recieves input from blue-sensitive cones show an overt asymmetry of the frequency of ON-center and OFF-center varieties, an asymmetry not present in ganglion cells whose center receives input from the other two cone types. A similar asymmetry of ON/OFF responses is found in the local electrotetinogram (d-wave) mediated by signals from blue-sensitive cones. ‘Blue-ON-center’ ganglion cells have larger receptive-field centers and shorter conduction latencies than other opponent-color varieties, suggesting an appreciable degree of receptor convergence and presumably large cell bodies. Intracellular stainings of these neurons with Procion Yellow show that they correspond to diffuse stratified (Parasol) ganglion cells whose flat-topped dendritic arborization stratifies in the sclerad half of the inner plexiform layer. In view of the known characteristics of macaque bipolar cells and of the ON/OFF asymmetry, it is proposed that these ganglion cells are postsynaptic to cone-specific flat bipolars possibly mediating sign-inverting synaptic contacts. The results also indicate a reversal, for the blue-cone pathway, of the ON/OFF lamination of the inner plexiform layer that has recently been described in other species.     

Mechanism of action of tubocurarine on nicotinic cholinoreceptors of neurons of the sympathetic ganglia of rats

Tubocurarine (Tc) effect on membrane currents elicited by acetylcholine (ACh) was studied in isolated superior cervical ganglion neurons of rat using patch-clamp method in the whole-cell recording mode. The "use-dependent" block of ACh current by Tc was revealed in the experiments with ACh applications, indicating that Tc blocked the channels opened by ACh. Mean lifetime of Tc-open channel complex, tau, was found to be 9.8 +/- 0.5 s (n = 7) at -50 mV and 20-24 degrees C. tau exponentially increased with membrane hyperpolarization (e-fold change in tau corresponded to the membrane potential shift by 61 mV). Inhibition of the ACh-induced current by Tc (3-30 microM/1) was completely abolished by membrane depolarization to the level of 80-100 mV. Inhibition of ACh-induced current was augmented at increased ACh doses. It is concluded that the open channel block produced by Tc is likely to be the only mechanism for Tc action on nicotinic acetylcholine receptors in superior cervical ganglion neurons of rat.