White matter abnormalities in children and adolescents with temporal lobe epilepsy

Background and Purpose

The widespread propagation of synchronized neuronal firing in seizure disorders may affect cortical and subcortical brain regions. Diffusion tensor imaging (DTI) can noninvasively quantify white matter integrity. The purpose of this study was to investigate the abnormal changes of white matter in children and adolescents with focal temporal lobe epilepsy (TLE) using DTI.

Materials and Methods

Eight patients with clinically diagnosed TLE and eight age- and sex-matched healthy controls were studied. DTI images were obtained with a 3-T magnetic resonance imaging scanner. The epileptic foci were localized with magnetoencephalography. Fractional anisotropy (FA), mean diffusivity (MD), parallel (λ_||) and perpendicular (λ_⊥) diffusivities in the genu of the corpus callosum, splenium of the corpus callosum (SCC), external capsule (EC), anterior limbs of the internal capsule (AIC), and the posterior limbs of the internal capsule (PIC) were calculated. The DTI parameters between patients and controls were statistically compared. Correlations of these DTI parameters of each selected structure with age of seizure onset and duration of epilepsy were analysed.

Results

In comparison to controls, both patients' seizure ipsilateral and contralateral had significantly lower FA in the AIC; PIC and SCC and higher MD, λ_|| and λ_⊥ in the EC, AIC, PIC and SCC. The MD, λ_|| and λ_⊥ were significantly correlated with age of seizure onset in the EC and PIC. λ_|| was significantly correlated with the duration of epilepsy in the EC and PIC.

Conclusion

The results of the present study indicate that children and adolescents with TLE had significant abnormalities in the white matter in the hemisphere with seizure foci. Furthermore, these abnormalities may extend to the other brain hemisphere. The age of seizure onset and duration of epilepsy may be important factors in determining the extent of influence of children and adolescents TLE on white matter.     

Helicobacter pylori determination in non-municipal drinking water and epidemiological findings

Background.?Studies conducted in Europe as well as in North and South America have tried to link Helicobacter pylori colonization with the drinking water supply, especially since H. pylori is known to survive quite well in water.

Methods.?In 2000, a cohort of 1884 grade-two children from two rural counties surrounding the city of Leipzig, Germany (77.4% of the 1991/1992 birth cohort) were tested for H. pylori colonization using the [¹³C]urea breath test. A parent-completed questionnaire elicited details on living conditions and lifestyle habits including questions on the children's drinking water from sources other than public water supplies, swimming in natural waters, etc.

In a second independent study, samples of well water, taken from 157 private wells still used in the two counties, were being tested for the presence of H. pylori, using polymerase chain reaction (PCR) method to determine relevant target DNA fragments of H. pylori.

Results.?In county I, 5.7% of the children and in county II 6.6% tested H. pylori-positive. Cluster analyses of the questionnaire data in both counties pointed to ‘drinking water from other than municipal sources’, as the closest H. pylori-associated cluster variable. The cluster estimations were supported by odds ratio (OR) calculations with an OR?=?16.4 (95% confidence interval (CI) 3.1,…,88.5) for county I and OR?=?4.0 (95% CI 1.3,…,12.4) for county II.

The PCR analyses showed H. pylori DNA fragments in 10.8% of the wells in county I and 9.2% in county II. The detection limit was set at 10 DNA copies corresponding to 125?bacteria/L, the average infestation of these wells was 931?bacteria/L.

Conclusion.?Despite the fact that the microbiological and epidemiological data do not correspond except that both studies were conducted in the same geographical areas, the independent findings of H. pylori in well water in the same general areas where children do seem to drink water other than from the public water supply suggests that water may be an important source of H. pylori infection.     

儿童额叶癫痫临床和长程视频脑电图特征

目的通过对46例儿童额叶癫痫患儿的临床表现、长程视频脑电图（VEEG）特点进行分析,提高对儿童额叶癫痫的认识。方法收集2008年12月至2014年8月儿科门诊及住院确诊的46例儿童额叶癫痫病例的资料,回顾性分析其临床表现、VEEG及神经影像学等特征。结果本组患儿发病年龄最小11个月,最大15岁。46例患儿共监测到临床发作258次,明确临床发作34例,14.7%仅于清醒期发作,61.8%仅在睡眠期发作,23.5%在清醒、睡眠中均有发作;临床发作形式包括额叶失神、局部阵挛发作、偏转性强直、姿势性强直、过度运动性自动症、口咽自动症、发声、发笑发作、临床下放电和自主神经性发作等。73.9%患儿记录到发作间期额叶为主的癫痫样放电,63.0%患儿记录到发作期额叶为主的癫痫样放电。结论儿童额叶癫痫临床发作频繁、短暂,以睡眠期发作为主,临床表现复杂多样,易漏诊;长程VEEG可监测到儿童额叶癫痫发作期临床及异常脑电图表现,可提供明确诊断率。     

肺炎支原体肺炎患儿急性期和恢复期血浆H-ficolin和L-ficolin水平分析

目的了解肺炎支原体肺炎患儿急性期和恢复期血浆中H-ficolin、L-ficolin水平的变化。方法采用ELISA法检测85例肺炎支原体肺炎患儿急性期和恢复期血浆H-ficolin、L-ficolin水平,并进行相关性分析。结果急性期H-ficolin水平1.8~25.2μg/ml,平均（11.9±5.9）μg/ml,恢复期H-ficolin水平0.3~26.5μg/ml,平均（10.1±5.7）μg/ml,急性期明显高于恢复期（Z=2.161,P=0.031）。急性期L-ficolin水平0.2~10.6μg/ml,平均（4.5±2.3）μg/ml,恢复期L-ficolin水平0.03~10.2μg/ml,平均（4.6±2.2）μg/ml,急性期和恢复期无统计学差异（t=0.245,P=0.807）。患儿急性期血浆H-ficolin水平与L-ficolin水平明显相关（r=0.22,P=0.039）。结论H-ficolin可能参与儿童肺炎支原体肺炎疾病过程。     

94例发锌发钙值偏低患儿的临床主症分析与疗效观察

分析了９４例患儿头发微量元素含量。结果表明：患儿厌食、偏食、反复上呼吸道感染、多汗与体内微量元素与必需元素异常关系密切,特别是锌、钙缺乏更为明显。根据祖国医学“脾呼则口能知五味”、“肺主气属卫”的理论,采用针刺以疏通经络,调整脾胃功能,内服锌、钙制剂脉动这脾通便、补益肺气等中药治疗,治疗时间短,疗效提高,临床有效率达９０％以上。     

The singing/acting child: a speech-languagepathologist''s perspective

Performance-oriented children who encounter voice problems benefit from a team approach to intervention. Developmental and psychosocial issues in addition to the acquisition of information and vocal skills must be addressed. This article presents information from a speech-language pathologist's perspective and includes some examples of clinical approaches and strategies. The importance of building motivation to change vocal habits and the need for the child to develop insight and self-evaluation strategies is emphasized.     

124例缺锌儿童补锌疗效观察

对１２４例１￣５岁缺锌儿童进行补锌疗效观察，结果表明，患儿身高、体重及症状体征均有明显改善，治疗总有效率达７８．１％，提示补锌４￣６周并配合饮食治疗，即可对缺锌引起的一系列病变有非常明显的疗效。     

营养不良儿血锌浓度的调查研究

取79例营养不良小儿血20μL，用国产MP-1型溶出分析仪．以极谱法检测其血锌浓度．按1985年全国9省城区儿童生长发育衡量数值，用WZR-EA型电脑评价营养不良程度．结果表明，44．3％的营养不良儿缺锌，营养不良程度与缺锌率成正比，6月龄至3岁营养不良儿最易缺锌，纯母乳喂养，按时合理添加辅食是预防婴幼儿缺锌的重要方法。微量血锌测定法简便易行，可推广试用．     

幼儿园与散居儿童微量元素差异的研究

测定了２８７例１－８岁的幼儿园儿童及散居儿童头发中Ｚｎ，Ｆｅ，Ｃｕ，Ｃａ，Ｍｎ和Ｐｂ的含量，并研究了两类儿童头发中上述元素含量的差异。结果表明，两类獐各元素间的相关性相似，各元素含量的平均值与其中位数相似，但散居儿童与幼儿园儿童相比，各元素含量的波动范围较大，有益元素铁和钙和平均值较低，且低于正常值的比例较高，而有害元素２铅依度平均则较高，超过允许值的比例也高，上述三种元素具有非常显著的差异。