BACKGROUND & AIMS: OBJECTIVES:Monochorionic (MC) twins are at increased risk of early fetal loss secondary to vascular complications such as twin-twin transfusion syndrome (TTTS). This study compared the early perinatal loss rates between MC and dichorionic (DC) twins in an era of invasive treatment for TTTS. METHODS:This was a retrospective study of all twin pregnancies of known chorionicity from a large regional cohort of nine hospitals over a 10-year period. Ultrasound data were matched to hospital delivery records and to a mandatory national register of pregnancy losses. Prospective risk of pregnancy loss from 14 to 24 weeks' gestation was calculated and the survival trend of MC and DC twins was analyzed using Kaplan-Meier survival analysis. RESULTS:The analysis included 3117 twin pregnancies (605 MC and 2512 DC). The total risk of early pregnancy loss (miscarriage and neonatal death) before 24 weeks was significantly higher in MC twins (60.3 per 1000 fetuses) than in DC twins (6.6 per 1000 fetuses), with a relative risk of 9.18 (95% CI, 6.0-13.9). Survival analysis showed a significant difference in overall and early mortality between MC and DC twins (log-rank test, P < 0.0001), while no difference was noted after 24 weeks' gestation (log-rank test, P = 0.08). CONCLUSIONS:Early pregnancy loss is significantly more common in MC than in DC twins, but no difference in the prospective risk of mortality between MC and DC twins is evident after 24 weeks' gestation. The observed early mortality rate has almost halved in comparison with previous studies in the published literature. Early detection and prompt treatment of complications in MC twins are likely to have contributed to this improvement in outcome.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:Interleukin-17 (IL-17), which is secreted by Th17 cells, is a proinflammatory cytokine that is implicated in the pathogenesis of multiple sclerosis (MS) and plays a role in nonresponse of MS patients to interferon-β (IFN-β) therapy. OBJECTIVES:The purpose of this study was to establish a correlation between nonresponders (NR) and IL-17A serum titers and binding antibodies (BAbs) to IFN-β, as well as to find a correlation between IL-17A serum levels and other features of MS patients. METHODS:Our prospective study included 72 inactive relapsing-remitting multiple sclerosis (RRMS) patients that had been treated for at least 18 months with IFN-β and 15 healthy subjects. We determined the serum levels of IL-17A and of BAbs. IL-17A levels were considered elevated (IL-17A+) if the recorded value was greater than 1.6 pg/ml. RESULTS:Twenty-seven patients (37.5%) were NR and had a significantly higher serum IL-17A level compared to the responders group. Nineteen patients (26.4%) were IL-17A+ and had had a significantly higher number of relapses in the previous year and a higher Expanded Disability Status Score. The majority of IL-17A+ patients were NR and had a shorter MS duration. CONCLUSIONS:RRMS patients with high serum IL-17A levels do not respond well to IFN-β therapy and have shorter MS duration compared to patients with low IL-17A levels. This response is not influenced by the presence of BAbs.

背景与目标：

BACKGROUND & AIMS: :Molecular dynamics simulations in explicit water were carried out for two stacks, each composed of six 10-strand antiparallel β-sheets for two peptides corresponding to the diverging turn of two homologous Abl-SH3 domains. The first system, referred to as 10×6×MK contained the DLSFMKGE sequence from the Drosophila, while the second one, referred to as 10×6×KK, contained the human DLSFKKGE sequence. It was found that the 10×6×MK β-sheet stack is stable, but the 10×6×KK β-sheet stack is not. The stability of the 10×6×MK β-sheet stack results from the hydrophobic interactions of the methionine and phenylalanine residues and the leucine residues of the neighboring sheets. The Met, Phe, and Leu hydrophobic units make a hydrophobic core for the stack of β-sheets. During the MD run, the Met, Phe, and Leu residues of the neighboring β-sheets acted as a conformational switch moving the β-sheets so that the Phe residue interacted with the Met residue from the neighboring β-sheet. Replacement of Met by Lys destroys the hydrophobic core, which is the stability factor of the β-sheet stack. For the 10×6×KK system, individual β-sheets were preserved during simulations, but the interactions between the β-sheets were lost. The calculations of a six β-sheet stack confirm the conclusion drawn from our earlier studies of single β-sheet systems that the β-sheets must form stacks to be stabilized. These results suggest that the two conserved basic residues at the diverging turn of SH3 domains could act as gatekeepers to avoid aggregation.

背景与目标： : 在显式水中对两个堆栈进行了分子动力学模拟，每个堆栈由两个肽的六个10链反平行 β-折叠组成，对应于两个同源Abl-SH3域的发散转向。第一个系统 (称为10 × 6 × mk) 包含果蝇的DLSFMKGE序列，而第二个系统 (称为10 × 6 × kk) 包含人类DLSFKKGE序列。发现10 × 6 × mk β-折叠堆叠是稳定的，而10 × 6 × kk β-折叠堆叠则不稳定。10 × 6 × mk β-薄片堆叠的稳定性是由蛋氨酸和苯丙氨酸残基与相邻薄片的亮氨酸残基的疏水相互作用引起的。Met，Phe和Leu疏水单元为 β-折叠堆叠形成疏水核心。在MD运行期间，相邻 β-sheet的Met，Phe和Leu残基充当构象开关，移动 β-sheet，以使Phe残基与相邻 β-sheet的Met残基相互作用。用Lys代替Met会破坏疏水核，这是 β-折叠堆叠的稳定性因子。对于10 × 6 × kk系统，在模拟过程中保留了单个 β-折叠，但是 β-折叠之间的相互作用丢失了。六个 β-sheet堆栈的计算证实了我们先前对单个 β-sheet系统的研究得出的结论，即 β-sheet必须形成堆栈才能稳定。这些结果表明，在SH3结构域发散的转弯处的两个保守的碱性残基可以充当网守以避免聚集。

BACKGROUND & AIMS: :Over an 8 year period, 170 patients with multiple sclerosis (MS) and 134 healthy controls were assessed at monthly intervals in order to ascertain environmental factors which might be important in producing exacerbation or progression of the illness, and to compare the frequency of common viral infections in the two groups. During cumulative periods designated "at risk" (2 weeks before the onset of infection until 5 weeks afterwards) annual exacerbation rates were almost 3-fold greater than those during periods not at risk. Approximately 9% of infections were temporally related to exacerbations, whereas 27% of exacerbations were related to infections. Frequency of common infections was approximately 20-50% less in MS patients than controls; it was progressively less in those with greater disability. Even in minimally disabled patients with similar potential for infectious contacts, the infection rate was significantly less than in controls, suggesting that MS patients could have superior immune defences against common viruses.

背景与目标： : 在8年的时间里，每月对170名多发性硬化症 (MS) 患者和134名健康对照者进行评估，以确定可能对疾病恶化或进展很重要的环境因素，并比较两组中常见病毒感染的频率。在指定为 “处于危险中” 的累积期间 (感染发作前2周至之后5周)，年恶化率几乎是无危险期间的3倍。大约9% 的感染在时间上与恶化有关，而27% 的恶化与感染有关。MS患者的常见感染频率比对照组低约20-50%; 残疾程度较高的患者逐渐减少。即使在具有类似感染接触潜力的最小残疾患者中，感染率也明显低于对照组，这表明MS患者可以对普通病毒具有出色的免疫防御能力。

BACKGROUND & AIMS: Mees' lines, or transverse striate leukonychia, are classically associated with arsenic poisoning, but have been described in other cases of acute or chronic illness. Their pathogenesis is thought to be a disruption of nail plate keratinization secondary to systemic stress. Mees' lines are observed in a patient with helminthic and amebic infections and no history of arsenic exposure. This case demonstrates another clinical setting in which Mees' lines can appear, providing further evidence that Mees' lines may chronicle systemic disease.

背景与目标： Mees线或横纹白斑病通常与砷中毒有关，但在其他急性或慢性疾病病例中也有描述。它们的发病机理被认为是继发于全身压力的指甲板角质化的破坏。在患有蠕虫和阿米巴感染且没有砷暴露史的患者中观察到mees的行。该病例展示了另一种可能出现Mees' 线的临床环境，提供了进一步的证据表明Mees' 线可能会记录全身性疾病。

BACKGROUND & AIMS: :Stem cells have been widely assumed to be capable of replacing lost or damaged cells in a number of diseases, including Parkinson's disease (PD), in which neurons of the substantia nigra (SN) die and fail to provide the neurotransmitter, dopamine (DA), to the striatum. We report that undifferentiated human neural stem cells (hNSCs) implanted into 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine-treated Parkinsonian primates survived, migrated, and had a functional impact as assessed quantitatively by behavioral improvement in this DA-deficit model, in which Parkinsonian signs directly correlate to reduced DA levels. A small number of hNSC progeny differentiated into tyrosine hydroxylase (TH) and/or dopamine transporter (DAT) immunopositive cells, suggesting that the microenvironment within and around the lesioned adult host SN still permits development of a DA phenotype by responsive progenitor cells. A much larger number of hNSC-derived cells that did not express neuronal or DA markers was found arrayed along the persisting nigrostriatal path, juxtaposed with host cells. These hNSCs, which express DA-protective factors, were therefore well positioned to influence host TH+ cells and mediate other homeostatic adjustments, as reflected in a return to baseline endogenous neuronal number-to-size ratios, preservation of extant host nigrostriatal circuitry, and a normalizing effect on alpha-synuclein aggregation. We propose that multiple modes of reciprocal interaction between exogenous hNSCs and the pathological host milieu underlie the functional improvement observed in this model of PD.

背景与目标： : 人们普遍认为干细胞能够替代许多疾病中丢失或受损的细胞，包括帕金森氏病 (PD)，其中黑质 (SN) 的神经元死亡，无法向纹状体提供神经递质多巴胺 (DA)。我们报告了植入1-甲基-4-苯基-1,4，2,3-四氢吡啶处理的帕金森氏灵长类动物中的未分化人类神经干细胞 (hNSCs) 存活，迁移并通过行为改善定量评估具有功能影响在这个DA-缺陷模型中，其中帕金森氏征与DA水平降低直接相关。少数hNSC后代分化为酪氨酸羟化酶 (TH) 和/或多巴胺转运蛋白 (DAT) 免疫阳性细胞，这表明受损的成年宿主SN内部和周围的微环境仍允许通过反应性祖细胞发展DA表型。发现大量不表达神经元或DA标记的hNSC衍生细胞沿持续的黑质纹状体路径排列，与宿主细胞并列。因此，这些表达DA保护因子的hNSCs可以很好地影响宿主TH细胞并介导其他稳态调节，这反映在恢复到基线内源性神经元数量与大小之比，保留现存的宿主黑质纹状体回路以及对 α-突触核蛋白聚集的正常化作用。我们建议外源性hNSCs与病理性宿主环境之间相互作用的多种模式是该PD模型中观察到的功能改善的基础。

BACKGROUND & AIMS: :Multiple endocrine neoplasia type 1 is an autosomal dominant cancer syndrome characterized by pituitary, parathyroid and enteropancreatic endocrine tumors, which is caused by germline mutations of the tumor suppressor gene MEN1. In the case reported here, the patient had family with this disease whose germline MEN1 mutation was undetectable by conventional sequencing analysis. Further investigations involving polymorphism analyses, gene dose assay and nucleotide sequencing identified a large germline deletion of approximately 29 kilobase pairs spanning the whole MEN1 gene. The deletion was flanked by Alu repetitive sequences, suggesting unequal homologous recombination as the deletion mechanism. The polymorphism linkage data suggested that an asymptomatic son of the proband did not carry the family mutation. More direct evidence was obtained by gene dose assay and deletion-specific polymerase chain reaction, which demonstrated the normal MEN1 gene dosage and the absence of the deletion breakpoints in this asymptomatic subject and thus definitely excluded the possibility of disease predisposition.

背景与目标： : 多发性内分泌肿瘤1型是一种常染色体显性显性癌症综合征，其特征是垂体，甲状旁腺和肠胰腺内分泌肿瘤，由抑癌基因men1的种系突变引起。在此处报道的病例中，患者患有该疾病的家族，其生殖系MEN1突变无法通过常规测序分析检测到。涉及多态性分析，基因剂量测定和核苷酸测序的进一步研究确定了跨越整个MEN1基因的大约29千碱基对的大量种系缺失。缺失的两侧是Alu重复序列，表明不相等的同源重组是缺失机制。多态性连锁数据表明，先证者的无症状儿子没有携带家族突变。通过基因剂量测定和缺失特异性聚合酶链反应获得了更直接的证据，这表明该无症状受试者的正常MEN1基因剂量和缺失断点的缺失，因此明确排除了疾病易感性的可能性。

BACKGROUND & AIMS: :This paper reports the proceedings of a consensus meeting on the incidence and complications of multiple gestation in Canada. In addition to background presentations about current and possible future practice in Canada, the expert panel also developed a set of consensus points. The need for infertility to be understood, and funded, as a healthcare problem was emphasized, along with recognition of the emotional impact of infertility. It was agreed that the goal of assisted reproduction treatment is the delivery of a single healthy infant and that even though many positive outcomes have resulted from twin or even triplet pregnancies, the potential risks associated with multiple pregnancy require that every effort be made to achieve this goal. The evidence shows that treatments other than IVF (such as superovulation and clomiphene citrate) contribute significantly to the incidence of multiple pregnancy. There is an urgent need for studies to understand better the usage and application of these other fertility technologies within Canada, as well as the non-financial barriers to treatment. The final consensus of the expert panel was that with adequate funding and good access to treatment, it will be possible to achieve the goal of reducing IVF-related multiple pregnancy rates in Canada by 50%.

背景与目标： : 本文报告了关于加拿大多次妊娠的发生率和并发症的共识会议的会议记录。除了关于加拿大当前和可能的未来做法的背景介绍之外，专家小组还制定了一套共识点。强调了将不孕症理解为医疗保健问题并为其提供资金的必要性，并认识到不孕症的情感影响。与会者一致认为，辅助生殖治疗的目标是分娩一个健康的婴儿，尽管双胞胎甚至三胞胎怀孕产生了许多积极的结果，但与多胎妊娠相关的潜在风险需要尽一切努力实现这一目标。证据表明，除IVF以外的其他治疗方法 (例如超排卵和柠檬酸克罗米芬) 对多胎妊娠的发生率有显着贡献。迫切需要进行研究，以更好地了解加拿大境内这些其他生育技术的使用和应用，以及治疗的非金融障碍。专家小组的最后共识是，有足够的资金和良好的治疗机会，将有可能实现到50% 年将加拿大与IVF相关的多胎妊娠率降低的目标。

BACKGROUND & AIMS: BACKGROUND:Recent studies show that patients with multiple nonsteroidal anti-inflammatory drug (NSAID) intolerance are frequently characterized by autoreactivity; this can be detected by autologous serum skin test (ASST). OBJECTIVE:To assess whether the autologous plasma skin test (APST), a test that was recently shown to be more sensitive than ASST, may be usefully employed as a predictive test for multiple NSAID intolerance in patients with a history of single NSAID intolerance. METHODS:Thirty otherwise normal adults with a history of acute urticaria following the ingestion of one single NSAID underwent an APST before being challenged with a COX-1-inhibiting NSAID other than the offending drug. RESULTS:Sixteen patients experienced urticaria following the ingestion of the alternative NSAID and were therefore classified as multiple NSAID reactors; all 16 (100%) scored positive on APST. In contrast only 3/14 patients finally classified as single NSAID reactors were positive on APST (p < 0.001). The positive and negative predictive value of APST for multiple NSAID intolerance were 86 and 100%, respectively. CONCLUSION:In patients with a history of acute urticaria induced by a single NSAID APST can be usefully employed to detect patients that are prone to react to NSAID other than the original offending one.

背景与目标：

BACKGROUND & AIMS: :Although the diagnosis of multiple sclerosis relies on the demonstration of disease dissemination in space and time, the exclusion of other neurological disorders is also essential. The limited specificity of abnormalities disclosed by MRI may increase the likelihood of diagnosis of multiple sclerosis in patients affected by other disorders. The available criteria for diagnosis of multiple sclerosis have not taken advantage of the potential of MRI to detect features "not suggestive" of multiple sclerosis. Recognition of such features in the work-up of patients suspected of having multiple sclerosis may reduce the likelihood of a false positive diagnosis of the disorder in some, while suggesting the correct alternative diagnosis in other patients. On the basis of this, a workshop of the European MAGNIMS (Magnetic Resonance Network in Multiple Sclerosis) was held to define a series of MRI red flags in the setting of clinically suspected multiple sclerosis that is derived from evidence-based findings and educated guesses. The presence of such red flags should alert clinicians to reconsider the differential diagnosis more extensively. In this review we will report on the conclusions of this international consensus, which should represent a first step beyond the concept of "no better explanation", and inform future diagnostic criteria for multiple sclerosis.

背景与目标： : 尽管多发性硬化症的诊断依赖于在空间和时间上对疾病传播的演示，但排除其他神经系统疾病也是必不可少的。MRI揭示的异常特异性有限可能会增加受其他疾病影响的患者诊断多发性硬化症的可能性。诊断多发性硬化症的可用标准尚未利用MRI的潜力来检测 “不暗示” 多发性硬化症的特征。在怀疑患有多发性硬化症的患者的检查中识别此类特征可能会降低某些患者对该疾病进行假阳性诊断的可能性，同时建议其他患者进行正确的替代诊断。在此基础上，举办了欧洲magims (多发性硬化症的磁共振网络) 研讨会，以定义一系列临床怀疑多发性硬化症的MRI危险信号，这些信号来自基于证据的发现和有根据的猜测。这种危险信号的出现应该提醒临床医生更广泛地重新考虑鉴别诊断疾病。在这篇评论中，我们将报告这一国际共识的结论，这应该代表 “没有更好的解释” 概念之外的第一步，并为未来多发性硬化症的诊断标准提供信息。

BACKGROUND & AIMS: :In order to study the antigenicity of envelope 46 kDa glycoprotein (gp46) of human T-cell leukemia virus type-I (HTLV-1), we have generated monoclonal anti-gp46 antibodies (MAbs), REY-7, REY-11, REY-16, REY-30, MET-2 and MET-3 from rats and mice. Immunoblot and immunofluorescence assays showed that these MAbs recognize gp46 and its related antigens, and specifically stained HTLV-I-bearing cells. All MAbs reacted with a recombinant gp46 antigen, N147, expressing the 147 amino acids in the C-terminal half of gp46. By using various synthetic peptides corresponding to the gp46 sequence, epitopes recognized by REY-7 and MET-3, REY-11 and REY-16, and REY-30 were mapped to regions corresponding to the amino acids 175-199, 253-282 and 288-312, respectively. MET-2 did not react with any of the peptides used. These results indicate that the present MABs are directed against at least 4 distinct epitopes expressed on the C-terminal half of gp46. The binding of these MAbs to gp46 was specifically inhibited by sera from HTLV-I-infected individuals, but none of these MAbs inhibited the cell fusion activity of HTLV-I.

背景与目标： : 为了研究人T细胞白血病病毒I型 (HTLV-1) 的包膜46 kda糖蛋白 (gp46) 的抗原性，我们从大鼠和小鼠中产生了单克隆anti-gp46抗体 (mab)，REY-7，REY-11，REY-16，REY-30，MET-2和MET-3。免疫印迹和免疫荧光测定表明，这些单克隆抗体识别gp46及其相关抗原，并特异性染色的HTLV-I携带细胞。所有mab均与重组gp46抗原N147反应，在gp46的C-末端一半表达147个氨基酸。通过使用对应于gp46序列的各种合成肽，将由REY-7和MET-3、REY-11和REY-16识别的表位和REY-30分别映射到对应于氨基酸175-199、253-282和288-312的区域。MET-2不与使用的任何肽反应。这些结果表明，本发明的mab针对在gp46的C末端一半上表达的至少4个不同的表位。这些单克隆抗体与gp46的结合被htlv-i感染个体的血清特异性抑制，但这些单克隆抗体均未抑制htlv-i的细胞融合活性。

BACKGROUND & AIMS: :The objective of this study was to answer the question of whether a double instead of triple embryo transfer strategy in patients over 38 years would substantially reduce the number of multiple pregnancies while maintaining the chance of a term live birth at an acceptable level. A randomized controlled two-centre trial was performed. Forty-five patients, 38 years or older, were randomized. Double embryo transfer over a maximum of four cycles (DET group) or triple embryo transfer over a maximum of three cycles (TET group) was performed. The cumulative term live birth rate was 47.3% after four cycles in the DET group and 40.5% after three cycles in the TET group. The difference between the DET and the TET group was 6.8% in favour of the DET group (95% CI -25 to 38). The multiple pregnancy rates in the DET and TET group were 0% (95% CI 0 to 24) and 30% (95% CI 7 to 65) respectively (P = 0.05). In the DET patients, the mean number of treatment cycles was 2.9 compared with 2.1 in the TET group (P = 0.01). In women of 38 years and older, double embryo transfer after IVF may result in similar cumulative term live birth rates compared with triple embryo transfer, provided that a higher number of treatment cycles is accepted.

背景与目标： : 这项研究的目的是回答以下问题: 在38岁以上的患者中采用双重而不是三重胚胎移植策略是否会大大减少多胎妊娠的数量，同时将足月活产的机会保持在可接受的水平。进行了一项随机对照的两中心试验。45名38岁或以上的患者被随机分组。进行了最多四个周期的双胚胎移植 (DET组) 或最多三个周期的三胚胎移植 (TET组)。在DET组中，在四个周期后47.3% 累积足月活产率，在TET组中，在三个周期后40.5%。DET和TET组之间的差异6.8% 有利于DET组 (95% CI -25至38)。DET组和TET组的多次妊娠率分别为0% (95% CI 0 ~ 24) 和30% (95% CI 7 ~ 65) (P = 0.05)。在DET患者中，平均治疗周期数与TET组的2.1相比2.9 (P = 0.01)。在38岁及以上的女性中，如果接受更多的治疗周期，IVF后的双胚胎移植可能会导致与三胚胎移植相似的累积足月活产率。

BACKGROUND & AIMS: An 18 month old girl with an angiographically measured ductus of 4.5 mm underwent transcatheter occlusion of the persistent arterial duct with a 17 mm Rashkind umbrella and an occluding spring coil. Severe intravascular haemolysis developed 20 hours later. Significant residual ductal leakage was noted and the residual duct measured 6 mm. Previous underestimation might have been related to ductal spasm as a catheter was placed across the duct before angiography. The haemolysis was abolished within 48 hours by a previously unreported approach of antegrade transcatheter closure of the residual duct by multiple spring coils.

背景与目标： 一名18个月大的女孩，其血管造影测量的4.5毫米导管，用17毫米的Rashkind伞和阻塞的弹簧线圈经导管闭塞了持续性动脉导管。20小时后出现严重的血管内溶血。注意到明显的残余导管泄漏，并且6毫米测量了残余导管。先前的低估可能与导管痉挛有关，因为在血管造影之前将导管穿过导管放置。通过先前未报道的通过多个弹簧线圈顺行经导管闭合残余导管的方法，在48小时内消除了溶血。

BACKGROUND & AIMS: :Thirty-five patients with definite multiple sclerosis (MS) were studied. They underwent neuropsychological testing and magnetic resonance imaging (MRI). The MRI findings at different brain areas levels were compared with the neuropsychological findings. A quantitative system was used to measure MRI-MS lesions. In this series, a positive correlation was established between memory and learning disturbances measured by Battery 144, and the lesions measured by MRI (total, hemispheric and, particularly, periventricular lesions). MRI can detect MS lesions, and this study shows that a correlation between MRI and neuropsychological findings is possible if quantitative methods are used to distinguish different MS involvement areas in relation to neuropsychological tasks. These findings suggest that hemispheric lesions in MS produce cognitive disturbances and MRI could be a useful tool in predicting memory and learning impairment.

背景与目标： : 研究了35例确诊的多发性硬化症 (MS) 患者。他们接受了神经心理学测试和磁共振成像 (MRI)。将不同脑区水平的MRI表现与神经心理学表现进行比较。定量系统用于测量MRI-MS病变。在该系列中，通过电池144测量的记忆和学习障碍与通过MRI测量的病变 (总，半球，特别是脑室周围病变) 之间建立了正相关。MRI可以检测MS病变，这项研究表明，如果使用定量方法区分与神经心理学任务有关的不同MS受累区域，则MRI与神经心理学发现之间的相关性是可能的。这些发现表明，MS的半球病变会产生认知障碍，MRI可能是预测记忆和学习障碍的有用工具。

BACKGROUND & AIMS: :Bilateral synchronous epileptiform discharges registered in patients with partial epilepsies may be generated by different pathophysiological mechanisms. Differentiation between underlying mechanisms is often crucial for correct diagnosis and adequate treatment in clinical epileptology. The aim of this study was to model in rats two possible mechanisms--secondary bilateral sychrony and interaction between multiple epilepic foci. Furthermore, to describe in detail semiology, laterality and differences in motor phenomena. Secondary bilateral synchrony was modeled by unilateral topical application of bicuculline methiodide (BMI) over the sensorimotor cortex. Bilateral symmetric application of BMI was used as a model of multiple epileptic foci. Electrographic and behavioural phenomena were recorded for 1h following the application of BMI. Electroencephalogram in both groups was characterized by presence of bilateral synchronous discharges. Myoclonic and clonic seizures involving forelimb and head muscles represented the most common motor seizure pattern in both groups. Significant differences were found in the laterality of motor phenomena. Motor seizures in unilateral foci always started in the contralateral limbs whereas symmetrical foci exhibited bilateral independent onset of convulsions. Similar lateralization was observed in interictal motor phenomena (myoclonic jerks). An important influence of posture on epileptic motor phenomena was demonstrated. Active or passive changes in animal posture (verticalization to bipedal posture) caused conversion from unilateral myoclonic jerks or clonic seizures to bilaterally synchronous (generalized) motor phenomena in both groups.

背景与目标： : 部分性癫痫患者的双侧同步癫痫样放电可能是由不同的病理生理机制产生的。潜在机制之间的区分对于临床表皮病的正确诊断和适当治疗通常至关重要。这项研究的目的是在大鼠中建立两种可能的机制-继发性双侧粘连和多个表位灶之间的相互作用。此外，要详细描述符号学，偏侧性和运动现象的差异。次级双侧同步性是通过在感觉运动皮层上单方面局部应用双苏氨酸甲碘化物 (BMI) 来模拟的。双侧对称应用BMI被用作多个癫痫灶的模型。应用BMI后1小时记录了电学和行为现象。两组的脑电图均以双侧同步放电为特征。涉及前肢和头部肌肉的肌阵挛和阵挛性癫痫发作是两组中最常见的运动癫痫发作模式。在运动现象的偏侧性方面发现了显着差异。单侧病灶的运动性癫痫发作总是在对侧肢体开始，而对称性病灶表现出双侧独立的抽搐发作。在发作间运动现象 (肌阵挛抽搐) 中观察到类似的偏侧化。证明了姿势对癫痫运动现象的重要影响。动物姿势的主动或被动变化 (垂直化为两足姿势) 导致两组患者从单侧肌阵挛抽搐或阵挛性癫痫发作转变为双侧同步 (广义) 运动现象。