Selective excitation of vibrational states by shaping of light-induced potentials

In this Letter we describe a method for population transfer using intense, ultrafast laser pulses. The selectivity is accomplished by careful shaping of light-induced potentials (LIPs). Creation and control of the LIPs is accomplished by choosing pairs of pulses with proper frequency detunings and time delays. As an example, selective population transfer is demonstrated for a three-state model of the sodium dimer.

Continuous positive air pressure eliminates nocturnal stridor in multiple system atrophy. Barcelona Multiple System Atrophy Study Group

We prospectively studied the sleep patterns and laryngeal function of 20 patients with multiple system atrophy and found sleep disturbances in all subjects and vocal cord abduction dysfunction in 14 (70%). In three patients with nocturnal stridor and complete vocal cord abductor dysfunction, continuous positive airways pressure eliminated laryngeal stridor, obstructive apnoea, and haemoglobin desaturation.

No evidence of linkage to 6p markers in spanish families with juvenile myoclonic epilepsy

Juvenile myoclonic epilepsy (JME) is a common subtype of hereditary generalized epilepsy with an uncertain pattern of inheritance. Different studies in multiple families have provided evidence for and against linkage of the disease to chromosome 6p. We performed linkage analysis using microsatellite markers from 6p (D6S109, D6S248, D6S291, D6S426, D6S272, D6S466, D6S294, D6S257) and from centromeric 6q region (D6S402) in seven small families of Spanish origin. The highest LOD scores were obtained under an autosomal dominant inheritance model with a penetrance of 70% but a significant positive LOD score (Z>3) was not reached. LOD scores<-2 were obtained at different markers in three of our families. These results support the concept of genetic heterogeneity in the disease.

An investigation of the early effects of manual lung hyperinflation in critically ill patients

This prospective within-group multicentre study was designed to assess the safety and short-term effectiveness of manual lung hyperinflation in mechanically ventilated patients. Eighteen patients from the intensive care units of two tertiary institutions were included and acted as their own control. Manual lung hyperinflation treatment involved patient positioning (side-lying), suctioning and manual lung hyperinflation. Side-lying treatment involved patient positioning and suctioning alone. Patients received both treatments on the day of data collection. Results demonstrated significant improvement for static respiratory system compliance (P = 0.001) with manual lung hyperinflation treatment compared to side-lying treatment. Manual lung hyperinflation treatment also cleared a significantly greater wet weight of sputum (P = 0.039). There were no differences between manual lung hyperinflation and side-lying treatment for gas exchange (PaO2/FIO2 and PaCO2), mean arterial pressure or heart rate. In conclusion, total static respiratory system compliance and sputum clearance were improved by the addition of manual hyperinflation to a physiotherapy treatment of positioning and suctioning in mechanically ventilated patients without compromise to cardiovascular stability or gas exchange.

Unilateral thalamic stroke does not decrease ipsilateral sleep spindles

STUDY OBJECTIVES

To measure the sleep spindle characteristics in patients with unilateral thalamic stroke.

DESIGN

A prospective study of patients with thalamic stroke and age-matched healthy controls.

SETTING

Department of Neurology of a University Hospital.

PARTICIPANTS

Thirteen patients (mean age: 67 years, SD: 13,44) with an isolated, unilateral acute thalamic stroke and 18 healthy age-matched volunteers.

INTERVENTIONS

A polysomnogram recording from 14 scalp EEG electrodes performed during 2 consecutive nights, the second or third week after the stroke. Only the sleep of the second night was analyzed.

MEASUREMENTS AND RESULTS

Sleep spindles were counted during two separate 10-minute epochs of stage II. Spindles appearing synchronously in both sides with similar amplitude were called "bilateral." Spindles with twice the amplitude in one side than the other were "right" or "left-side predominant". There were 8 patients with posterolateral, 3 with global and 2 with anterior lesions. Eight were right and 5 left-sided. The number of spindles was similar in patients (39.8 +/- 23.4 in 20 minutes) than controls (26.07 +/- 29.07; p=0.173). Spindles with a centroparietal (34%) and centroparieto-occipital localization (22%) were the most frequent. In controls approximately 66% of the spindles had a bilateral and symmetric distribution over the scalp, 23% of the spindles were predominantly left-sided and 5% were predominantly right-sided. In patients, bilateral spindles decreased (p<0.0001) but asymmetric spindles did not change.

CONCLUSION

Unilateral acute thalamic stroke does not decrease sleep spindles ipsilaterally; rather, it seems to produce a bilateral diminution in their number.

Hyperkalemic periodic paralysis associated with multiple sleep onset REM periods

A 24-year-old man with sporadic hyperkalemic periodic paralysis (HPP) presented with moderate excessive daytime sleepiness and transitory episodes of weakness which occurred during and after sleep. Multiple sleep latency test (MSLT) demonstrated the presence of five sleep onset REM periods (SOREMPs) and a sleep latency of five minutes. Treatment with a diuretic which decreases serum potassium resolved all the clinical symtomps and a new MSLT showed the absence of SOREMPs and a sleep latency of 13.5 minutes. To our knowledge, the patient herein reported is the first case that associates sleep abnormalities and multiple SOREMPs with HPP. Furthermore, the present case suggests that SOREMPs may be explained by an increased extracellular potassium conductance related to HPP.

[The treatment of epilepsy. A therapeutic guide of the Catalan Society of Neurology]

INTRODUCTION

There have been major advances in the treatment of epilepsy over the past ten years, leading to marked changes in the way this illness is treated. However, the introduction of new drugs and new non-drug treatments have led to uncertainty in the medical profession with regard to their exact indications. For this reason, a group of neurologists of the Catalan Society of Neurology have drawn up guide-lines for the treatment of epilepsy.

DEVELOPMENT

A panel of eight neurologists with a special interest in the diagnosis and treatment of epilepsy reviewed the literature to assess the data available regarding the treatment of epilepsy. A joint document was drawn up describing the basic rules for the use of antiepileptic drugs and the indications for other non-drug treatments.

CONCLUSION

This document is an approved therapeutic guide to the treatment of epilepsy.

Immunohistochemical localization of neurotrophins and neurotrophin receptors in human and mouse salivary glands

This study was undertaken to analyze the occurrence of low- (p75) and high-affinity (TrkA, TrkB and TrkC) neurotrophin receptor proteins in human and mouse salivary glands using immunohistochemistry. Furthermore, the presence of neurotrophins was also investigated. The study was carried out on 14 human (4 parotid, 6 submandibular and 4 sublingual glands) and 5 mouse salivary glands, using polyclonal antibodies against Trk proteins. The intensity of immunostaining was calculated automatically and evaluated in arbitrary units of grey levels. In human tissues no immunoreactivity (IR) for the assessed antigens was observed in the serous or mucous acinar cells, although TrkA IR was found in the acini of the submandibular gland. The cells of the intercalated ducts showed p75 IR (sublingual) and TrkA IR (parotid gland). The striated and excretory ducts displayed p75 IR, TrkA IR and TrkC IR in all glands, but TrkB IR was never detected. No neurotrophins were detected. In the mouse glands the ductal cells display IR for p75 (submandibular) and Trks A and C (parotid and submandibular) but not the sublingual gland. Acinar cells of the submandibular gland also show p75 IR. The only neurotrophin found in the mouse salivary glands was NGF (submandibular gland). These results suggest that neurotrophins may be involved in controlling the physiology of epithelial salivary cells.

Radiologic variables of clinical significance in the extraction of impacted mandibular third molars

OBJECTIVE

To determine which radiologic variables have a clinical significance in the extraction of impacted mandibular third molars.

STUDY DESIGN

A prospective study was carried out on 100 consecutive extractions of unilateral impacted mandibular third molars (60 women and 40 men, mean age: 26.27 +/- 10.63 years). Fourteen radiologic variables were ordinally evaluated, establishing their relation to the surgical intervention time. The Kruskal-Wallis test, a multivariant analysis of the principal components, the Pearson correlation coefficient, and logistical regression tests were carried out.

RESULTS

Seven variables (occlusal plane, relation to the second molar, depth, follicle, periodontal ligament width, ramus of the mandible, and angulation) demonstrated a statistically significant relation to the surgical intervention time (Kruskal-Wallis tests, p < 0.007). Two associated variables, depth and periodontal ligament width, showed the most powerful and simple relation to the surgical intervention time (r2 multiple = 0.307, p < 0.001).

CONCLUSION

The model we propose is a tool that may help the general practitioner to establish competence in an extraction of the impacted mandibular third molar by measuring the association of two radiologic variables: depth and periodontal ligament width.

What is the relationship between arachnoid cysts and seizure foci?

PURPOSE

Arachnoid cysts are sometimes encountered in MRIs performed for a variety of reasons. In patients with epilepsy, particularly those with refractory epilepsy, arachnoid cysts are often assumed to be related to their seizure focus. We conducted a study to investigate this putative relationship.

METHODS

A retrospective study on the incidence of arachnoid cysts was performed in patients seen in our Epilepsy Clinic who had CT or MRI scans, interictal EEGs or ictal EEGS. Locations of seizure foci in these patients were defined from clinical and electrophysiologic data.

RESULTS

Seventeen of 867 patients had arachnoid cysts. Twelve patients had temporal lobe cysts and only 3 of them had temporal lobe seizures. Four patients had frontal lobe cysts and only 1 had frontal lobe seizures ipsilateral to the cyst. One patient had a cerebello-pontine angle cyst and frontal lobe seizures. Thus, clinical manifestations of seizures and EEG findings (interictal and/or ictal) indicated that the seizure focus was adjacent to the cysts in only 4 patients (23.5%).

CONCLUSIONS

Our findings suggest that arachnoid cysts are often an incidental finding in patients with epilepsy and do not necessarily reflect the location of the seizure focus.

Mercury distribution and renal metallothionein induction after subchronic oral exposure in rats

The effects of long-term daily intake of low and high levels of mercury on its organ distribution and binding to renal metallothionein (MT) in male rats were studied. The animals were exposed to mercuric chloride labelled with 203Hg via drinking water for 8 weeks (5, 50 and 500 microM Hg). The greatest concentration of mercury was found in the kidneys. Similar levels of radioactivity in the buccal cavity and oesophagus were also observed by whole-body autoradiography. In the kidneys, the mercury was accumulated in the outer stripe of the outer zone of the medulla and, to a minor degree, in the renal cortex. Almost 50% the total renal mercury was associated to MT. The binding capacity of the renal MT for mercury tends to saturate with increasing doses, thus this means that the capacity of the kidneys to accumulate mercury is limited.

Incision Depth vs. Incision Number in the Rupture Strength of Pig Eyes Following Radial Keratotomy

The effects of incision depth and the number of incisions on globe rupture were studied in porcine enucleated eye model. In one group, radial keratotomy was performed using a diamond blade set at 100%, 75%, and 50% of corneal thickness. In another set of eyes, 16, 8, and 4 incisions were made with the diamond knife set at 100% of corneal thickness. The eyes were then subjected to blunt trauma. The mean energy of globe rupture for incisions at 100%, 75%, and 50% of corneal thickness was 3.0, 4.2, and 4.6 joules respectively. In contrast, mean energy of globe rupture for 16, 8, and 4 incisions at 100% corneal thickness was 2.8, 2.9, and 3.0 joules, respectively. This study suggests that incision depth in radial keratotomy reduces the strength of the cornea more than incision number.

Cyclosporine-associated mutism in liver transplant patients

Four liver transplant recipients treated with cyclosporine developed a reversible neurologic syndrome characterized by a speech disorder leading to mutism. This complication, previously reported in a few liver transplant recipients treated with the immunosuppressive drug FK506, had not been described with cyclosporine. Recognition of this syndrome should prompt withdrawal of the drug and avoidance of unnecessary diagnostic procedures.

Whole-body retention, and urinary and fecal excretion of mercury after subchronic oral exposure to mercuric chloride in rats

The effects of long-term daily intake of mercury on its urinary and fecal excretion, whole-body retention, and blood concentration in male rats were observed. The animals were exposed to mercuric, chloride labeled with 203Hg via drinking water for 8 weeks (5, 50 and 500 microM Hg). 203Hg in urine, feces and blood was quantified. The blood mercury concentration did not keep a linear relationship with the increasing dose. The percentage of the total amount of mercury intake which is excreted by the fecal route in rats exposed to 500 microM Hg was significantly lower than in those exposed to 5 and 50 microM. The daily dose percentage of mercury excreted in urine increased with dose size. The results show that the absorption fraction of mercury through the gastrointestinal tract (30-40%) was higher than values previously reported.