癫痫发作间期和亚临床发作期脑SPECT痫灶定位？…

目的：研究癫痫亚临床发作期和发作间期脑ＳＰＥＣＴ的痫灶定位诊断价值。方法：建立亚临床发作期脑血流灌注显像方法，与间期显像对比分析定位；并结合脑ＣＴ、ＥＥＧ、ＥＣｏＧ和疗效综合评价其痫灶定位诊断价值。结果：间期ＳＰＥＣＴ阳性率、准确率、灵敏度分别为：９０．９１％、７７．２７％、８９．４７％，亚临床发作期分别为：９５．４５％、９０．９１％、１００％，优于传统定位诊断。亚临床发作期病灶放射性摄影比值也有     

癫痫发作间期和亚临床发作期脑SPECT痫灶定位对比研究

目的：研究癫痫亚临床发作期和发作间期脑ＳＰＥＣＴ的痫灶定位诊断价值。方法：建立亚临床发作期脑血流灌注显像方法，与间期显像对比分析定位；并结合脑ＣＴ、ＥＥＧ、ＥＣｏＧ和疗效综合评价其痫灶定位诊断价值。结果：间期ＳＰＥＣＴ阳性率、准确率、灵敏度分别为：９０．９１％、７７．２７％、８９．４７％，亚临床发作期分别为：９５．４５％、９０．９１％、１００％，优于传统定位诊断。亚临床发作期病灶放射性摄取比值也有明显增加，ＥＣｏＧ、病检阳性率１００％，远期随访有效率９０．９１％。结论：ＳＰＣＥＴ具有较高的痫灶定位诊断价值，运用亚临床发作期显像可明显提高痫灶定位阳性率、准确性和灵敏度，表明亚临床发作期ＳＰＥＣＴ安全易行，能呈现ｒＣＢＦ增加，反映出发作期的显像特征     

发作间期PET和SPECT检查对颞叶癫痫定位诊断价值

目的：探讨发作间期１８Ｆ－脱氧葡萄糖（ＦＤＧ）正电子发射断层扫描（ＰＥＴ）和９９ｍＴｃ－己撑半脱氨酸（ＥＣＤ）单光子发射断层扫描对顽固性颞叶癫痫（ＴＬＥ）的定位诊断价值。方法：５３例脑电图（ＥＥＧ）定位明确的顽固性ＴＬＥ患者分别行发作间期１８Ｆ－ＦＤＧＰＥＴ和９９ｍＴｃ－ＥＣＤＳＰＥＣＴ检查。其中２１例磁共振（ＭＲＩ）显示有结构性病变并与ＥＥＧ定位结果一致。结果：ＭＲＩ异常组均在ＰＥＴ和ＳＰＥＣＴ相应部位出现低代谢和低灌注表现。ＭＲＩ正常组，ＰＥＴ定位准确性为８４．５％，显著高于ＳＰＥＣＴ的５６．３％（Ｐ＜０．０５）。结论：对于无结构性病变的颞叶癫痫，发作间期ＰＥＴ检查有较高的定位诊断价值，ＳＰＥＣＴ的临床意义相对较小     

脑SPECT对小儿癫痫的临床诊断价值

1980年Ｓｔｏｋｅｌｙ[1]等首次应用单光子发射计算机断层(ＳＰＥＣＴ)成功地检查了癫痫病人的脑血流,随着ＳＰＥＣＴ和脑血流显像剂发展,目前ＳＰＥＣＴ已成为癫痫定位的有效方法,我们用99ｍＴｃ—乙撑双半胱氨酸二乙酯(ＥＣＤ)作ＳＰＥＣＴ脑血流显像对31例小儿癫痫病人进行检测,并与ＣＴ,ＭＲＩ,ＥＥＧ对比分析,旨在探讨99ｍＳＰＥＣＴ脑血流显像对小儿癫痫的定位诊断价值资　　料1993年8月至1995年12月临床诊断的小儿癫痫31例,其中男22例,女9例,年龄3个月至14岁,于发作间期用ＳＰＥＣＴ测定局部脑血流量(ｒＣＢＦ),其中ＣＴ检查21例,Ｍ…     

额叶癫痫的诊断—形态与功能定位的对比

本文对２８例额叶癫痫病人的ＥＥＧ，ＣＴ，ＳＰＥＣＴ检查定位结果进行了对比研究，结果显示：８５．７％的病人发作间期和／或发作期ＥＥＧ有额叶定位征象，两者结合可提高定位诊断阳性率及准确率。ＣＴ检查仅４２．９％发现额叶损害，仍是重要辅助诊断手段。     

钙拮抗剂对高血压脑出血局部脑血流的影响及其临床变化？…

目的：动态观察尼莫地平对高血压脑出血患者局部脑血流及其临床疗效的影响。方法：随机将６９例高血压脑出血患者分为对照组和尼莫地平治疗组，并行ＳＰＥＣＴ和临床疗效的动态观察。图像的处理和临床疗效的评定采用盲法分析。结果：治疗组在ＳＰＥＣＴ和临床疗效的改善方面显著低于对照组。结论：尼莫地平可改善高血压脑出血后的局部脑血流下降和伴随的临床变化。     

缺血性脑血管病~（99m）TC—ECD脑血流灌注SPECT显像

本文报告４８例缺血性脑血管病的单光子发射型计算机断层（ＳＰＥＣＴ）脑血流灌注显像结果，４４例异常（９２％）。２９例与Ｘ—ＣＴ进行了对比观察，结果表明：ＳＰＥＣＴ脑血流显像对缺血性脑血管病的诊断、定位以及治疗的选择均有很高价值。     

癫痫手术前SPECT的定位价值

癫痫手术前ＳＰＥＣＴ的定位价值沈国富，孙克华，谭启富，冯宣我们对１２例癫痫患者行发作间期及１例美解眠诱发后的脑局部血流ＳＰＥＣＴ检查，结果显示ＳＰＥＣＴ较之ＣＴ．ＭＲＩ、ＥＥＧ具有更高的阳性率，其定位的阳性率达到了８０％以上，美解眠诱发后可能会增加结...     

SPECT脑血流灌注显像在眩晕患者中的初步应用

目的评价乙撑双半胱氨酸二乙酯（＾９９ｍＴｃ－ＥＣＤ）ＳＰＥＣＴ脑血流灌注显像对眩晕患者的诊断价值。方法对１９列眩晕患者和２０例正常对照者进行ＳＰＥＣＴ脑血流灌注显像。结果突发性耳聋组和诊断未明确组的患者全部出现局部脑血流量下降,且多数分布在颞叶;梅尼埃病患者组则较少出现局部脑血流量下降（４０％,２／５）;正常对照组未发现局部脑血流量下降。结论＾９９ｍＴｃ－ＥＣＤＳＰＥＣＴ脑血流灌注显像有助于眩晕患     

自发性脑出血SPECT研究

报告３０例自发性脑出血后脑血流改变的ＳＰＥＣＴ研究结果。结果发现全部患者ＳＰＥＣＴ显示脑血流量的下降区域均超过ＣＴ病灶范围，７例血流量下降局限于病灶区，余２３例见广泛缺血，其中小脑失联络９例，基底节区出血对脑血流的影响超过脑叶出血，血流下降的范围与出血量有关，且与神经功能恢复程度有一定联系。本文提示脑出血在积极控制水肿的同时，应注意改善亚急性期和恢复期脑部低灌注。     

Developing methods for assessing quality of life in different cultural settings

Abstract. Background: This review traces the 12-year history of an international collaboration of researchers—the WHOQOL Group—who were brought together by the World Health Organisation to develop and produce a cross-cultural measure of quality of life for use in health and health care. Discussion: The theoretical and philosophical basis of the WHOQOL instrument is outlined as it evolved throughout the design and adjustment of a reflexive methodology that places an assessment of the users views at the centre of health care. The stages of research are further expanded and explained in recounting the scientific experience of this unique collaboration. The WHOQOL is available in 40 countries and most majority languages. Adaptations exist for assessing particular conditions, e. g. spirituality, religion and personal beliefs.1 The paper is based on data and experience obtained as part of the WHO study to develop a QoL measure (WHOQOL). The collaborators in this study have been at WHO Geneva: Dr. Norman Sartorius, Dr. J. Orley, Dr. Willem Kuyken and Dr. Mick Power. In the Field Research Centres collaborating investigators are Prof. Helen Herrman, Dr. H. Schofield and Ms B. Murphy, Univ. of Melbourne, Australia, Prof. Z. Metelko, Prof. S. Szabo and Mrs. M. Pibernik-Okanovic, Institute of Diabetes, Endocrinology and Metabolic Diseases and Dept. of Psychology, Faculty of Philosophy, Univ. of Zagreb, Croatia, Dr. N. Quemada and Dr. A. Caria, INSERM, Paris, France, Dr. S. Rajkumar and Mrs. Shuba Kumar, Madras Medical College, India, Dr. S. Saxena, All India Institute of Medical Sciences, Delhi, India, Dr. D. Baron and Dr. M. Amir, Ben Gurion Univ., Beer Sheeva Israel, Dr. Miyako Tazaki, Dept. of Science, Science Univ. of Tokyo, Japan and Dr. Ariko Noji, Dept. of Community Health Nursing, St. Lukes College of Nursing, Japan, Dr. G. van Heck and Mrs. J. de Vries, Tilburg Univ., The Netherlands, Prof. J. Arroyo-Sucre and Prof. Pichard-Ami, Univ. of Panama, Panama, Prof. M. Kabanov, Dr. A. Lomachenkov, and Dr. G. Burkovsky, Bekhterev Psychoneurological Institute, St. Petersburg, Russia, Dr. R. Lucas Carrasco, Barcelona, Spain, Dr. Yooth Bodharamik and Mr. Kitikorn Meesapya, Institute of Mental Health, Bangkok, Thailand, Dr. S. Skevington, Dept. of Psychology, Univ. of Bath, Bath, UK, Dr. D. Patrick, Ms M. Martin and Ms D. Wild, Univ. of Washington, Seattle, USA and Prof.W. Acuda and Dr. J. Mutambirwa, Univ. of Zimbabwe, Harare,Zimbabwe. An international panel of consultants includes: Dr. N. K. Aaronson, Dr. P. Bech, Dr. M. Bullinger, Dr. He-Nian Chen, Dr. J. Fox-Rushby, Dr. C. Moinpur and Dr. R. Rosser. Consultants who have advised WHO at various stages of the development of the project have included: Dr. D. Buesching, Dr. D. Bucquet, Dr. L. W. Chambers, Dr. B. Jambon, Dr. C. D. Jenkinson, Dr. D. De Leo, Dr. L. Fallowfield, Dr. P. Gerin, Dr. P. Graham, Dr. O. Gureje, Dr. K. Kalumba, Dr. Kerr-Corea, Dr. C. Mercier, Mr. J. Oliver, Dr. Y. H. Poortinga, Dr. R. Trotter and Dr. F. van Dam     

Hemispheric lateralization in an analysis of speech sounds. Left hemisphere dominance replicated in Japanese subjects

Evoked magnetic responses to speech sounds [R. N??t?nen, A. Lehtokoski, M. Lennes, M. Cheour, M. Huotilainen, A. Iivonen, M. Vainio, P. Alku, R.J. Ilmoniemi, A. Luuk, J. Allik, J. Sinkkonen and K. Alho, Language-specific phoneme representations revealed by electric and magnetic brain responses. Nature, 385 (1997) 432-434.] were recorded from 13 Japanese subjects (right-handed). Infrequently presented vowels ([o]) among repetitive vowels ([e]) elicited the magnetic counterpart of mismatch negativity, MMNm (Bilateral, nine subjects; Left hemisphere alone, three subjects; Right hemisphere alone, one subject). The estimated source of the MMNm was stronger in the left than in the right auditory cortex. The sources were located posteriorly in the left than in the right auditory cortex. These findings are consistent with the results obtained in Finnish [R. N??t?nen, A. Lehtokoski, M. Lennes, M. Cheour, M. Huotilainen, A. Iivonen, M.Vainio, P.Alku, R.J. Ilmoniemi, A. Luuk, J. Allik, J. Sinkkonen and K. Alho, Language-specific phoneme representations revealed by electric and magnetic brain responses. Nature, 385 (1997) 432-434.][T. Rinne, K. Alho, P. Alku, M. Holi, J. Sinkkonen, J. Virtanen, O. Bertrand and R. N??t?nen, Analysis of speech sounds is left-hemisphere predominant at 100-150 ms after sound onset. Neuroreport, 10 (1999) 1113-1117.] and English [K. Alho, J.F. Connolly, M. Cheour, A. Lehtokoski, M. Huotilainen, J. Virtanen, R. Aulanko and R.J. Ilmoniemi, Hemispheric lateralization in preattentive processing of speech sounds. Neurosci. Lett., 258 (1998) 9-12.] subjects. Instead of the P1m observed in Finnish [M. Tervaniemi, A. Kujala, K. Alho, J. Virtanen, R.J. Ilmoniemi and R. N??t?nen, Functional specialization of the human auditory cortex in processing phonetic and musical sounds: A magnetoencephalographic (MEG) study. Neuroimage, 9 (1999) 330-336.] and English [K. Alho, J. F. Connolly, M. Cheour, A. Lehtokoski, M. Huotilainen, J. Virtanen, R. Aulanko and R.J. Ilmoniemi, Hemispheric lateralization in preattentive processing of speech sounds. Neurosci. Lett., 258 (1998) 9-12.] subjects, prior to the MMNm, M60, was elicited by both rare and frequent sounds. Both MMNm and M60 sources were posteriorly located in the left than the right hemisphere.     

Book Reviews

Book reviewed in this article:
Clinical Applications of Evoked Potentials in Neurology (Advances in Neurology, Vol. 32), Jean Courjon, Frangois Mauguiére, and Michel Revol
Phenomenology and Treatment of Psychophysiological Disorders, William E. Fann, Ismet Karacan, Alex D. Pokorny, and Robert L. Williams
Neonatal Neurology, Gerald M. Fenichel
A Textbook of Biological Feedback, Marietta Fischer-Williams, Alfred J. Nigl, and David L. Sovina
Toxicologic Emergencies: A Comprehensive Handbook in Problem Solving, 2nd Ed., Lewis R. Goldfrank
Nervous System Toxicology, C. L. Mitchell
Clinical Neuroepidemiology, F. C. Rose
Adverse Effects of Antiepileptic Drugs, D. Schmidt and L. Seldon
Computed Tomography of the Head and Spine. A Photographic Color Atlas of CT, Gross, and Microscopic Anatomy, H. N. Schnitzlein, E. W. Hartley, F. R. Murtagh, L. Grundy, and J. J. Fargher
Geriatric Neurology: Selected Topics, W. R. Slade
Neurology for the Non-Neurologist, William J. Weiner and Christopher G. Goetz     

Book Reviews

Book reviewed in this article:
The Amygdaloid Complex, Yehezkel Ben-Ari (ed.). Elsevier
Basic Concepts and Methods (Fundamentals of EEG Technology, Vol. 1), Fay S. Tyner, John R. Knott, and W. Br em Mayer, Jr. Raven Press
Care of the Neurologically Handicapped Child. A Book for Parents and Professionals, A. L. Prensky and H. S. Palkes
Epilepsy. A Handbook for Patients, Parents, Families, Teachers, Health and Social Workers, Allen H. Middleton, Arthur A. Attwell, and Gregory O. Walsh
Essentials of Clinical Neurology, Leon A. Weisberg, Richard L. Strub, and Carlos A. Garcia
Harrison's Principles of Internal Medicine (10th ed.), Robert G. Petersdorf, Raymond D. Adams, Eugene Braunwald, Kurt J. Is-selbacher, Joseph B. Martin, and Jean D. Wilson (eds.)
Hughlings Jackson on Psychiatry, Kenneth Dewhurst
Psychopharmacology of Anticonvulsants, Merton Sandler (ed.)     

The Environment and Staff of Residential Facilities: Findings from the Italian ‘Progres’ National Survey

We administered structured interviews to managers and staff of a random sample of 265 Italian psychiatric Residential Facilities (RFs). Most are independent buildings, located in urban and suburban areas. The median number of residents is 10. The few RFs (5.7%) with more than 20 beds have a higher rate of drop-outs and escapes. The average indoor space per resident is 36 square meters, there is often a garden, and residents generally live in two-bed rooms. Most facilities are located within walking distance of shopping centers or recreational facilities. Three-quarters have 24-hour staff coverage. On average, each facility has about 10 full-time equivalent workers, with a staff:resident ratio of 0.92. Most of the professional input is provided by nurses and auxiliary staff. Critical issues to be considered in planning facilities include the physical environment, the size, and the staffing patterns. Angelo Picardi, Giovanni de Girolamo, and Pierluigi Morosini are affiliated with the National Mental Health Project, Italian National Institute of Health, Rome, Italy.Giovanni Santone is affiliated with the Psychiatric Clinic, United Hospitals of Ancona and University of Marche, Ancona, Italy.Ian Falloon is affiliated with the University of Auckland, Auckland, New Zealand.Angelo Fioritti is affiliated with the Program on Mental Health and Pathological Dependence, AUSL of Rimini, Rimini, Italy.Rocco Micciolo is affiliated with the Chair of Biostatistics, University of Trento, Trento, Italy.Enrico Zanalda is affiliated with the Department of Mental Health, Turin, Italy.The PROGRES Group includes: National Coordinators: G. de Girolamo, M.D., A. Picardi, M.D., P. Morosini, M.D. (National Mental Health Project, National Institute of Health, Rome); Biostatistician: R. Micciolo, M.D. (University of Trento); Regional Coordinators: P. Argentino, M.D., G. Borsetti, M.D., M. Casacchia, M.D., P. Ciliberti, M.D., G. Civenti, M.S.W., A. Colotto, M.D., G. Dell’Acqua, M.D., W. Di Munzio, M.D., G. Fagnano, D.Psyc., A. Fioritti, M.D., N. Longhin, M.D., M. Miceli, M.D., M. Nicotera, M.D., M. Pisetta, R. Putzolu, E. Rossi, M.D., M.E. Rotunno, M.D., D. Semisa, M.D., R. Tomasi, M.D., P. Tulli, D.Psyc., E. Zanalda, M.D.     

Risk factors for a first generalized tonic-clonic seizure in adult life

To evaluate risk factors for a first generalized tonic-clonic seizure (GTCS) in adults (=15 years), we performed a multicenter, case-control study involving eleven first-referral neurological departments in north-western Italy. The study enrolled 278 patients with a first GTCS, and 556 age- and sex-matched hospital controls. Cases and controls were interviewed through a questionnaire (inter-rater and index-proxy agreement varied between 75% and 100% for the different questions). Risk factors significantly associated with a first GTCS were: severe head trauma (odds ratio 9.9; 95% confidence limits 2.0–67.1), siblings with seizures (5.7; 1.7–21.4), alcohol intake >50 grams/day (4.9; 3.1–7.9), history of stroke (3.8; 1.8–8.0), complications of delivery (2.7; 1.5–5.1), other relatives with seizures (2.4; 1.3–4.6), sleep deprivation (2.4; 1.4–4.1), low gestational age (1.9; 1.1–3.4), mild-moderate head trauma (1.8; 1.2–3.0), and low birth weight (1.6; 1.0–2.7). Genetic and late acquired factors and life habits are major risk factors for a first GTCS in adults, while pre- and perinatal events play only a minor role. Received: 22 Novembre 2001 / Accepted in revised form: 11 June 2002 RID="*" ID="*"The Alcohol and Epilepsy Study Group includes: L. Sironi, Neurology Department, Regional Hospital, Aosta; F. Brignolio, E. Duc, V. Montano, A. Tribolo, Division of Neurology, Civil Hospital, Asti; V.Nardozza, M. Gionco, Division of Neurology, Ospedale degli Infermi, Biella; E. Grasso, P. Meineri, M.G. Rosso, Division of Neurology, Santa Croce Hospital, Cuneo; A. Villani, A. Margaroli, P. Julita, G. Savoini, Division of Neurology, S. Biagio Hospital, Domodossola; M.S. De Angelis, M. Gianelli, P. Naldi, E. Terazzi, Neurology Clinic, Maggiore della Carit/agrave; Hospital, Novara; G. Amedeo, A. Campanella, M. De Mattei, E. Rocci, P. Zaina, Neurology Department, Molinette Hospital, Turin; M. Nobili, L. Vivalda, D. Leotta, U. Morino, Division of Neurology, Martini Hospital, Turin; R. Bacci, D. Daniele, Division of Neurology, Mauriziano Hospital, Turin; R. Rubino, P. Provera, Division of Neurology, Civil Hospital, Tortona; M. Andreotti, D. Mittino, Division of Neurology, SS. Trinità Hospital, Varallo Sesia. Correspondence to M. Leone     

Book Reviews

Book reviewed in this article:
Brain, Behavior and Evolution, Vol. 1, No. 1, pp. 1–88, 1968, published by Karger, Basel, bimonthly.
The Electrical Activity of the Nervous System, a Textbook for Students, 3rd edition, by M. A. B. Brazier.
European Neurology (Succeeding Section B of Psychiatria et Neurologia, Vol. 154), Editor-in-Chief H. A. E. Kaeser, Karger, Basel.     

深圳市外来青年工人的心理健康状况调查

为了解外来青年工人的心理健康水平，采用９０项症状清单（ＳＣＬ－９０）、艾森克个性问卷（ＥＰＱ）、社会支持量表和自编劳动心理卫生调查表，对深圳市３７１名外来青年工人（研究组）的心理健康状况进行了调查，并与１００名当地青年工人（对照组）及全国常模比较。结果：研究组的ＳＣＬ－９０评定总均分、阳性症状均分以及强迫、人际敏感、恐怖３个因子分均显著高于对照组（Ｐ＜０．０５～０．０１）。外来青年工人心理健康水平低于当地青年工人，也低于全国常模。多因素分析显示，主要影响因素依次为：神经质程度、精神压力程度、收入、思家程度、婚恋情况、性格内外倾向、居住条件及社会地位。提示心理卫生工作者应加强对外来青年工人的心理辅导和咨询工作，预防心理障碍的发生     

Lipid mediators and their metabolism in the nucleous: implications for Alzheimer's disease

Lipid mediators are important endogenous regulators derived from enzymatic degradation of glycerophospholipids, sphingolipids, and cholesterol by phospholipases, sphingomyelinases, and cytochrome P450 hydroxylases, respectively. In neural cells, lipid mediators are associated with proliferation, differentiation, oxidative stress, inflammation, and apoptosis. A major group of lipid mediators, which originates from the enzymatic oxidation of arachidonic acid, is called eicosanoids (i.e., prostaglandins, leukotrienes, thromboxanes, and lipoxins). The corresponding lipid mediators of docosahexaenoic acid metabolism are named as docosanoids. They include resolvins, protectins (neuroprotectins), and maresins. Docosanoids produce antioxidant, anti-inflammatory, and antiapoptotic effects in brain tissue. Other glycerophospholipid-derived lipid mediators are platelet activating factor, lysophosphatidic acid, and endocannabinoids. Degradation of sphingolipids also results in the generation of sphingolipid-derived lipid mediators, such as ceramide, ceramide 1-phosphate, sphingosine, and sphingosine 1-phosphate. These mediators are involved in differentiation, growth, cell migration, and apoptosis. Similarly, cholesterol-derived lipid mediators, hydroxycholesterol, produce apoptosis. Abnormal metabolism of lipid mediators may be closely associated with pathogenesis of Alzheimer's disease.     

Books Received

Mc. Alpine, D., C. E. Lumsden, E. D. Acheson , A re-appraisal.
Smith, B. H. , Principles of Clinical Neurology
M. Mumenthaler, H. Schliack, Torben Fog , Läsionen periphärer Nerven
E. Ettlinger , Functions of the Corpus Callosum
J. C. Scotto , L'hyperostose frontale interne
D. Ingvar, N. Lassen , Regional Cerebral Blood Flow
Michaelis, L. , Orthopaedic surgery of the limbs in paraplegia
Adolf Juba , Pathologie des Ballismus
I. Taylor , The neurological mechanisms of hearing and speech in Children
F. Mellerio , L'electroencéphalographie dans les intoxications aigués
T. W. Farmer , Pediatric Neurology
P. Bourret, R. Louis , Anatomie du systéme nerveux central
M. Brazier , Brain Function. Vol. II. RNA and brain function; memory and learning
E. Gutmann, P. Hnik , The effect of use and disuse on neuromuscular functions
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