Intraoperative electrocorticography and successful focus resection in a case of Sturge-Weber syndrome

This paper reports a surgically treated case of Sturge-Weber syndrome (SWS) in which the epileptic foci and haemangiomatosis were successfully resected under monitoring of intraoperative electrocorticography. The patient was a 19-month-old female infant who was referred to our hospital because of frequent hemi-tonic-clonic convulsions that were resistant to anticonvulsant therapy. Serial MRI showed progressive atrophy in the left fronto-parieto-temporal lobe, and gyral enhancement by gadolinium corresponded to venous haemangiomatosis of SWS. Three-dimensional reconstruction of the MR images was performed using the Viewing Wand System. Conventional EEG taken before the operation showed slow activity in the left frontal lobe. Intraoperative ECoG revealed spike focus at the posterior temporal cortex to the margin of the haemangiomatosis. Lesionectomy with lobar corticectomy of the total frontal and parietal lobe and part of the temporal lobe was performed. The epileptogenic focus detected by ECoG in the posterior temporal lobe was also resected. In post-excisional ECoG, epileptogenic activities had disappeared. The patient had hemiparesis and hemihypesthesia just after the surgery, but gradually recovered from the paresis and almost has normal motor function except for right-hand clumsiness up to 1 year after surgery. The present study demonstrated that lobar corticectomy of the haemangiomatosis-affected cortex with resection of the neighbouring epileptogenic focus is a good surgical alternative even if a haemangiomatosis of the SWS affected multilobar corti of the hemisphere

Observation of finite excess noise in the voltage-biased quantum Hall regime as a precursor for breakdown

We performed noise measurements in a two-dimensional electron gas to investigate the nonequilibrium quantum Hall effect (QHE) state. While excess noise is perfectly suppressed around the zero-biased QHE state reflecting the dissipationless electron transport of the QHE state, considerable finite excess noise is observed in the breakdown regime of the QHE. The noise temperature deduced from the excess noise is found to be of the same order as the energy gap between the highest occupied Landau level and the lowest empty one. Moreover, unexpected finite excess noise is observed at a finite source-drain bias voltagesmaller than the onset voltage of the QHE breakdown, which indicates finite dissipation in the QHE state and may be related to the prebreakdown of the QHE.Comment: 8 pages, 8 figure

New method to create a vascular arteriovenous fistula in the arm with an endoscopic technique

AbstractWe describe a new technique in which the basilic vein is transposed subcutaneously with endoscopic surgery to create a vascular access in the arm. The vein was harvested with the Endoscopic Vascular Surgery System (Olympus Co, Tokyo, Japan). We could harvest a vessel about 25 cm long with endoscopy. After vessel transposition, an arteriovenous fistula was created in the usual manner. In all 10 patients, we created an effective blood access as scheduled before surgery. We could use the arteriovenous fistula 6 days after surgery and get blood flow in all cases. (J Vasc Surg 2002;36:635-8.

Positive feedback regulation of type I IFN genes by the IFN-inducible transcription factor IRF-7

AbstractThe interferon regulatory factor (IRF) family of transcription factors regulate the interferon (IFN) system, among which IRF-3 is involved in the virus-induced IFN-β gene expression. Here we show that another member IRF-7 is critical for the IFN-α gene induction. Unlike the IRF-3 gene, the IRF-7 gene is induced by IFNs through activation of the ISGF3 transcription factor, and IRF-7 undergoes virus-induced nuclear translocation. In cells lacking p48, an essential component of IFN stimulated gene factor 3 (ISGF3), ectopic expression of IRF-7 but not IRF-3 can rescue the deficiency to induce IFN-α genes. These results indicate that IRF-7 is a key factor in the positive feedback regulation of IFN-α/β production

Long-term Ultrasonographic Follow-up Study of Gastric Motility in Patients with Functional Dyspepsia

Although patients with functional dyspepsia complain of epigastric symptoms, the relation between these symptoms and gastric motility remains controversial. There are few reports on the clinical course of functional dyspepsia, including changes in gastric motility, observed over a considerably long period. We conducted a study to examine association between changes in symptoms and changes in ultrasonographically evaluated gastric motility over a long-term follow-up period in patients with functional dyspepsia. Forty patients (18 men, 22 women; mean age, 53.7 years) with functional dyspepsia were followed up by medical interview, physical examination, endoscopy, and ultrasonography for gastric motility. Follow-up ranged from 1.0 to 7.8 years (mean, 3.0 years). Ultrasonographic evaluation of gastric motility included gastric emptying rate and antral contractions. During the follow-up period, patients were treated with proton pump inhibitors, H2-blockers, or prokinetics. Symptoms improved in 21 patients (group A), but symptoms persisted or worsened in 19 patients (group B). There were no significant differences in clinical characteristics between the two groups. Gastric motility improved in group A but not in group B. In conclusion, improved gastric motility appears to correspond to and may explain improved symptoms in some patients with functional dyspepsia