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Sample records for amobarbital

  1. Intracarotid amobarbital testing for language and memory dominance in children.

    Science.gov (United States)

    Szabó, C A; Wyllie, E

    1993-07-01

    The intracarotid amobarbital procedure (IAP) was attempted in 22 pediatric epilepsy surgery candidates, ages 5-12 years old. With extra pre-test teaching and emotional preparation, adjusted amobarbital dosage for younger patients, and simplified test items tailored to the child's abilities, language and memory testing were accomplished after at least one injection for 19 (86%) of patients. Language dominance was clarified in 11 children overall (50% of patients), in all of the children who had bilateral testing and at least borderline intelligence (IQ > 70), and in 57% of the children with mild or moderate mental retardation. Memory assessment was accomplished in 18 children after amobarbital injection of the hemisphere ipsilateral to the predominant epileptogenic zone. IAP retention scores tended to be lower in children than adults, especially in the setting of mental retardation. Retention scores after ipsilateral injection were > 60% in all 10 of the children with at least borderline intelligence, but children with mental retardation. Retention scores after contralateral injection were > 60% in only four of 12 children. Our results suggested that a modified pediatric IAP protocol can clarify the hemisphere of language dominance in most verbal preadolescent children with at least borderline intelligence, and in many children with mental retardation. However, IAP memory retention scores tended to be lower in children than adults and should be interpreted with caution. PMID:8223420

  2. A comparison of propofol and amobarbital for use in the Wada test.

    LENUS (Irish Health Repository)

    Magee, James A

    2012-06-01

    129 Wada procedures were reviewed to examine the suitability of propofol (n=54) as a replacement to amobarbital (n=75) for use as an anaesthetic in the Wada test. Suitability was considered with respect to length of hemiplegia induced, the frequency of side effects and patient memory scores. Data was retrospectively collected from records of patients who had undergone the Wada procedure between 2004 and 2009 in Beaumont Hospital, Dublin. No significant differences were found between the two drugs on any of the measures. The results suggest that propofol represents a suitable alternative to amobarbital for use in the Wada procedure.

  3. Cerebral metabolic changes (F-18-FDG PET) during selective anterior temporal lobe amobarbital test

    NARCIS (Netherlands)

    Khan, N; Hajek, M; Antonini, A; Maguire, P; Muller, S; Valavanis, A; Leenders, KL; Regard, M; Schiess, R; Wieser, HG

    1997-01-01

    Cerebral glucose utilisation using F-18-fluorodeoxyglucose positron emission tomography (F-18-FDG PET) was measured in 4 patients with temporal lobe epilepsy during a selective anterior temporal lobe (TL) amobarbital test (ATLAT) and compared with their baseline values. F-18-FDG was injected intrave

  4. The intracarotid amobarbital procedure (Wada test with two protocols combined, Montreal and Seattle Procedimentos do amobarbital intracarotideo (teste de Wada com dois protocolos combinados, Montreal e Seattle

    Directory of Open Access Journals (Sweden)

    Paulo J. M. Leite

    1997-06-01

    Full Text Available The intracarotid amobarbital procedure was carried out in 8 male and 7 female candidates to temporal lobectomy, and a female candidate to frontal lesionectomy, aged 18-50 (mean 32.5 years. Language and memory were tested after injection in each hemisphere. Both were measured by the Montreal procedure. In 9 patients language and memory were evaluated with the Seattle procedure too. In 12 patients the left hemisphere was dominant for language; three had bilateral dominance. In I patient the Seattle procedure demonstrated the dominant hemisphere by relatively slowness of speech during the drug effect in the left hemisphere. Memory was defined to be in the left hemisphere in 12 patients, in the right in 2, bilateral in 1 and in another lateralization was not possible. In 1 patient memory dominance was determined by the Montreal protocol alone because of lack of cooperation. These early results indicate that the methods may be complementary for determination of language and memory dominance in epilepsy surgery candidates.O testo do amobarbital intracarotídeo foi realizado em 8 homens e 7 mulheres candidatos a lobectomia temporal e em uma mulher candidata a lesionectomia frontal, com idades de 18-50 (média 32,5 anos. Linguagem e memória foram testadas após a injeção do amobarbial em cada hemisfério cerebral. Todos os pacientes foram avaliados pelo método de Montreal e 9 também pelo método de Seattle. Em 12 pacientes o hemisfério cerebral esquerdo foi dominante para linguagem e em 3 pacientes houve dominância bilateral. Em uma paciente a linguagem foi determinada apenas através do método de Seattle, com lentificação relativa da fal a, sob ação da droga no hemisfério cerebral esquerdo. Dominância da memória à esquerda foi observada em 12 pacientes, à direita em 2, bilateral em 1 e em outro não foi lateralizada. Dominância da memória foi definida apenas através do método de Montreal em um paciente, devido à pouca coopera

  5. A case report of a Wada test after dominant hemisphere multiple hippocampal transections: Pathophysiology of confusion after amobarbital injection

    Directory of Open Access Journals (Sweden)

    Patrick Landazuri

    2014-01-01

    Full Text Available Dialepsis is defined as a predominant alteration of consciousness with preservation of motor tone and the ability to perform movements. While dialepsis is a common feature of both focal and generalized epilepsies, its precise symptomatogenic zone and pathogenesis remain undefined. This case report describes a patient who underwent intracarotid amobarbital procedures before and after dominant hemisphere multiple hippocampal transections. From our observations, we propose a possible pathogenesis for the generation of dialeptic seizures.

  6. Predictors of outcome after anterior temporal lobectomy: the intracarotid amobarbital test.

    Science.gov (United States)

    Sperling, M R; Saykin, A J; Glosser, G; Moran, M; French, J A; Brooks, M; O'Connor, M J

    1994-12-01

    The intracarotid amobarbital test (IAT) examines hemispheric memory and language. We set out to determine whether memory performance on the IAT correlated with seizure relief after anterior temporal lobectomy in 117 patients with refractory epilepsy. The IAT assessed recognition memory performance for nine items with correction for false-positive recognitions. We then compared performance of one hemisphere with that of the other, defining a correctly lateralized memory deficit as worse performance when using the hemisphere containing the operated temporal lobe than when using the other hemisphere. The analysis included concurrent factors that might also affect outcome, such as age at first risk for epilepsy, presence or absence of tumor, and Full Scale IQ. A discriminant function analysis demonstrated that patients with a correctly lateralized memory deficit on the IAT had an increased probability of being seizure-free following surgery after controlling for other predictors. The performance of the nonoperated temporal lobe related to outcome, although less strongly. The magnitude of the difference in performance between the two hemispheres and the performance of the operated hemisphere did not relate to outcome. Patients who became seizure-free had an earlier age at first risk than did those with persistent seizures, and tumor presence weakly correlated with postoperative outcome. IQ did not correlate with outcome. We conclude that the IAT predicts seizure relief after anterior temporal lobectomy independent of other known risk factors we examined. PMID:7991120

  7. Cerebral amobarbital sodium distribution during Wada testing: utility of digital subtraction angiography and single-photon emission tomography

    International Nuclear Information System (INIS)

    We aimed to determine if the cerebral distribution of anesthetic during Wada testing is reflected by findings on digital subtraction angiography (DSA) and single-photon emission computed tomography (SPECT) and if the findings on these studies are relevant to the outcome of the Wada test. We carried out selective internal carotid artery (ICA) DSA on 29 patients underwent studies prior to a Wada test. In patients without angiographic cross-filling, amobarbital and a radiotracer were injected into each ICA, beginning with the epileptogenic side. In patients with cross-filling, the ICA ipsilateral to the epileptogenic focus was injected with amobarbital and radiotracer while other was injected with amobarbital alone. We analyzed the DSA studies for cross-filling and filling of the posterior cerebral arteries (PCA). We reviewed the SPECT for activity in the territories of the anterior, middle cerebral, and posterior cerebral arteries. We compared the results of both studies with the success or failure of the neuropsychological portion of the Wada test. In 20 patients without cross-filling, the results of DSA and SPECT were comparable: symmetrical hemisphere activity was seen. In nine patients with cross-filling, SPECT showed bilateral, almost symmetrical activity. Filling or nonfilling of the PCA correlated with activity (or lack of it) in the medial temporal and occipital regions in all patients. The Wada test was considered successful in all patients. The findings on SPECT did not alter interpretation of the Wada test and we suggest that it may not be needed in all patients undergoing Wada testing. (orig.)

  8. Cerebral amobarbital sodium distribution during Wada testing: utility of digital subtraction angiography and single-photon emission tomography

    Energy Technology Data Exchange (ETDEWEB)

    Castillo, M.; Mukherji, S.K.; McCartney, W.H. [Department of Radiology, University of North Carolina School of Medicine, Chapel Hill, NC (United States)

    2000-11-01

    We aimed to determine if the cerebral distribution of anesthetic during Wada testing is reflected by findings on digital subtraction angiography (DSA) and single-photon emission computed tomography (SPECT) and if the findings on these studies are relevant to the outcome of the Wada test. We carried out selective internal carotid artery (ICA) DSA on 29 patients underwent studies prior to a Wada test. In patients without angiographic cross-filling, amobarbital and a radiotracer were injected into each ICA, beginning with the epileptogenic side. In patients with cross-filling, the ICA ipsilateral to the epileptogenic focus was injected with amobarbital and radiotracer while other was injected with amobarbital alone. We analyzed the DSA studies for cross-filling and filling of the posterior cerebral arteries (PCA). We reviewed the SPECT for activity in the territories of the anterior, middle cerebral, and posterior cerebral arteries. We compared the results of both studies with the success or failure of the neuropsychological portion of the Wada test. In 20 patients without cross-filling, the results of DSA and SPECT were comparable: symmetrical hemisphere activity was seen. In nine patients with cross-filling, SPECT showed bilateral, almost symmetrical activity. Filling or nonfilling of the PCA correlated with activity (or lack of it) in the medial temporal and occipital regions in all patients. The Wada test was considered successful in all patients. The findings on SPECT did not alter interpretation of the Wada test and we suggest that it may not be needed in all patients undergoing Wada testing. (orig.)

  9. Quantitation of amobarbital, butalbital, pentobarbital, phenobarbital, and secobarbital in urine, serum, and plasma using gas chromatography-mass spectrometry (GC-MS).

    Science.gov (United States)

    Johnson, Leonard L; Garg, Uttam

    2010-01-01

    Barbiturates are central nervous system depressants with sedative and hypnotic properties. Some barbiturates, with longer half-lives, are used as anticonvulsants. Their mechanism of action includes activation of gamma-aminobutyric acid (GABA) mediated neuronal transmission inhibition. Clinically used barbiturates include amobarbital, butalbital, pentobarbital, phenobarbital, secobarbital, and thiopental. Besides their therapeutic use, barbiturates are commonly abused. Their analysis is useful for both clinical and forensic proposes. Gas chromatography mass spectrometry is a commonly used method for the analysis of barbiturates. In the method described here, barbiturates from serum, plasma, or urine are extracted using an acidic phosphate buffer and methylene chloride. Barbital is used as an internal standard. The organic extract is dried and reconstituted with mixture of trimethylanilinium hydroxide (TMAH) and ethylacetate. The extract is injected into a gas chromatogram mass spectrometer where it undergoes "flash methylation" in the hot injection port. Selective ion monitoring and relative retention times are used for the identification and quantitation of barbiturates. PMID:20077060

  10. The lesioned brain: still a small world?

    Directory of Open Access Journals (Sweden)

    Johannes C Baayen

    2010-11-01

    Full Text Available The intra-arterial amobarbital procedure (IAP or Wada test is used to determine language lateralization and contralateral memory functioning in patients eligible for neurosurgery because of pharmaco-resistant epilepsy. During unilateral sedation, functioning of the contralateral hemisphere is assessed by means of neuropsychological tests. We use the IAP as a reversible model for the effect of lesions on brain network topology. Three artifact free epochs (4096 samples were selected from each EEG record before and after amobarbital injection. Functional connectivity was assessed by means of the synchronization likelihood (SL. The resulting functional connectivity matrices were constructed for all six epochs per patient in four frequency bands, and weighted network analysis was performed. The clustering coefficient, average path length, small-world-index, and edge weight correlation were calculated. Recordings of 33 patients were available. Network topology changed significantly after amobarbital injection: clustering decreased in all frequency bands, while path length decreased in the theta and lower alpha band, indicating a shift towards a more random network topology. Likewise, the edge weight correlation decreased after injection of amobarbital in the theta and beta bands. Network characteristics after injection of amobarbital were correlated with memory score: higher theta band small-world-index and increased upper alpha path length were related to better memory score. The whole-brain network topology in patients eligible for epilepsy surgery becomes more random and less optimally organized after selective sedation of one hemisphere, as has been reported in studies with brain tumor patients. Furthermore, memory functioning after injection seems related to network topology, indicating that functional performance is related to topological network properties of the brain.

  11. In silico Molecular Docking of Lavandula Angustifolia Mill’s compounds along with a number of antianxiety Drugs with GABAA receptor for reduce stress

    Directory of Open Access Journals (Sweden)

    Ali Kazemi Babaheydari

    2014-06-01

    Full Text Available GABAA receptor is hetero-oligomeric Cl- channel that is elective blocked by the alkaloid bicuculline and modulated by steroids, barbiturates and benzodiazepines. The anticonvulsant activity of Diazepam, Amobarbital and Phenobarbital may be mediated in Section by enhancement of inhibition involving y-aminobutyric acid (GABA. Lavender is one of the maximum effective medicinal plants various therapeutic effects of lavender, so as sedative, spasmolytic, antiviral, and antibacterial activities have been reportage. The molecular docking analyses done indicate the highly and effectively interactions between GABA and the Lavandula angustifolia Mill compounds. Ligand Lavandula angustifolia Mill compounds with GABAA are safer and milder with fewer or no side effects than the drugs currently used in the remedy of lessening high Stress which can be better for the development of new therapeutics to blocked GABAA lessening stress. Results confirm all the Lavandula angustifolia Mill compounds were good binding energy when compared with the binging energies of Diazepam, Amobarbital and Phenobarbital.

  12. Hippocampal Volumetry and Memory fMRI in Temporal Lobe Epilepsy

    OpenAIRE

    Mechanic-Hamilton, Dawn; Korczykowski, Marc; Yushkevich, Paul A.; Lawler, Kathy; Pluta, John; Glynn, Simon; Tracy, Joseph I.; Wolf, Ronald L.; Sperling, Michael R.; French, Jacqueline A.; Detre, John A

    2009-01-01

    This study examined the utility of structural and functional MRI at 1.5 and 3 Tesla (T) in the pre-surgical evaluation and prediction of post-surgical cognitive outcome in temporal lobe epilepsy (TLE). Forty-nine patients undergoing presurgical evaluation for temporal lobe (TL) resection and twenty-five control subjects were studied. Patients completed standard pre-surgical evaluations including, intracarotid amobarbital test (IAT) and neuropsychological testing. During functional imaging, su...

  13. Irreversible injury of isolated adult rat myocytes. Osmotic fragility during metabolic inhibition.

    OpenAIRE

    Ganote, C. E.; Vander Heide, R. S.

    1988-01-01

    Isolated myocytes can be established as a valid model for studying changes in cytoskeletal proteins during the development of irreversible injury only if isolated cells develop lesions similar to those that occur during irreversible injury to intact hearts, specifically osmotic fragility and subsarcolemmal blebs. In the first experiment, isolated cells were irreversibly injured by metabolic inhibition with 5 mM Iodoacetic acid (IAA) and 6 mM amobarbital (Amy). Osmotic fragility of control and...

  14. The lesioned brain: still a small world?

    OpenAIRE

    Baayen, Johannes C; Martin Klein; Dimitri N Velis; Alpherts, Willem C. J.; Reijneveld, Jaap C.; Cornelis Jan Stam

    2010-01-01

    The intra-arterial amobarbital procedure (IAP or Wada test) is used to determine language lateralization and contralateral memory functioning in patients eligible for neurosurgery because of pharmaco-resistant epilepsy. During unilateral sedation, functioning of the contralateral hemisphere is assessed by means of neuropsychological tests. We use the IAP as a reversible model for the effect of lesions on brain network topology. Three artifact free epochs (4096 samples) were selected from each...

  15. Effect of hypernatremia on injury caused by energy deficiency: role of T-type Ca2+ channel

    OpenAIRE

    Pastukh, Viktor; Chen, Hairu; Wu, Songwei; Jong, Chian Ju; Alexeyev, Mikhail; Schaffer, Stephen W

    2010-01-01

    Hypernatremia exerts multiple cellular effects, many of which could influence the outcome of an ischemic event. To further evaluate these effects of hypernatremia, isolated neonatal cardiomyocytes were chronically incubated with medium containing either normal (142 mM) or elevated sodium (167 mM) and then transferred to medium containing deoxyglucose and the electron transport chain inhibitor amobarbital. Chronic hypernatremia diminished the degree of calcium accumulation and reactive oxygen ...

  16. Multiwalled carbon nanotubes as a solid-phase extraction adsorbent for the determination of three barbiturates in pork by ion trap gas chromatography-tandem mass spectrometry (GC/MS/MS) following microwave assisted derivatization

    International Nuclear Information System (INIS)

    A new method was developed for the rapid screening and confirmation analysis of barbital, amobarbital and phenobarbital residues in pork by gas chromatography-tandem mass spectrometry (GC/MS/MS) with ion trap MSD. The residual barbiturates in pork were extracted by ultrasonic extraction, cleaned up on a multiwalled carbon nanotubes (MWCNTs) packed solid phase extraction (SPE) cartridge and applied acetone-ethyl acetate (3:7, v/v) mixture as eluting solvent and derivatized with CH3I under microwave irradiation. The methylated barbiturates were separated on a TR-5MS capillary column and detected with an ion trap mass detector. Electron impact ion source (EI) operating MS/MS mode was adopted for identification and external standard method was employed for quantification. One precursor ion m/z 169 was selected for analysis of barbital and amobarbital and m/z 232 was selected for phenobarbital. The product ions were obtained under 1.0 V excitation voltage. Good linearities (linear coefficient R > 0.99) were obtained at the range of 0.5-50 μg kg-1. Limit of detection (LOD) of barbital was 0.2 μg kg-1 and that of amobarbital and phenobarbital were both 0.1 μg kg-1 (S/N ≥ 3). Limit of quatification (LOQ) was 0.5 μg kg-1 for three barbiturates (S/N ≥ 10). Satisfying recoveries ranging from 75% to 96% of the three barbiturates spiked in pork were obtained, with relative standard deviations (R.S.D.) in the range of 2.1-7.8%

  17. Reversible blockade of complex I or inhibition of PKCβ reduces activation and mitochondria translocation of p66Shc to preserve cardiac function after ischemia.

    Directory of Open Access Journals (Sweden)

    Meiying Yang

    Full Text Available AIM: Excess mitochondrial reactive oxygen species (mROS play a vital role in cardiac ischemia reperfusion (IR injury. P66Shc, a splice variant of the ShcA adaptor protein family, enhances mROS production by oxidizing reduced cytochrome c to yield H2O2. Ablation of p66Shc protects against IR injury, but it is unknown if and when p66Shc is activated during cardiac ischemia and/or reperfusion and if attenuating complex I electron transfer or deactivating PKCβ alters p66Shc activation during IR is associated with cardioprotection. METHODS: Isolated guinea pig hearts were perfused and subjected to increasing periods of ischemia and reperfusion with or without amobarbital, a complex I blocker, or hispidin, a PKCβ inhibitor. Phosphorylation of p66Shc at serine 36 and levels of p66Shc in mitochondria and cytosol were measured. Cardiac functional variables and redox states were monitored online before, during and after ischemia. Infarct size was assessed in some hearts after 120 min reperfusion. RESULTS: Phosphorylation of p66Shc and its translocation into mitochondria increased during reperfusion after 20 and 30 min ischemia, but not during ischemia only, or during 5 or 10 min ischemia followed by 20 min reperfusion. Correspondingly, cytosolic p66Shc levels decreased during these ischemia and reperfusion periods. Amobarbital or hispidin reduced phosphorylation of p66Shc and its mitochondrial translocation induced by 30 min ischemia and 20 min reperfusion. Decreased phosphorylation of p66Shc by amobarbital or hispidin led to better functional recovery and less infarction during reperfusion. CONCLUSION: Our results show that IR activates p66Shc and that reversible blockade of electron transfer from complex I, or inhibition of PKCβ activation, decreases p66Shc activation and translocation and reduces IR damage. These observations support a novel potential therapeutic intervention against cardiac IR injury.

  18. Determination of language lateralization using functional MRI during the performance of shiritori tasks in neurosurgery patients

    International Nuclear Information System (INIS)

    Assessment of language lateralization is crucial in patients considered for neurological surgery. The authors used functional MRI (fMRI) in conjunction with shiritori, a kind of word-generation task as paradigms, to determine language lateralization in the patients. We used a 1.5 Tesla magnetic resonance imaging devise with an echo-planar imaging sequence. Thirty-two patients undergoing neurological surgery would alternately rest and silently perform shiritori during fMRI acquisition. Language lateralization was determined in 29 out of 32 patients. Twenty-two patients were considered as left-hemisphere dominant and seven were right-hemisphere dominant. Brain activation was seen in the prefrontal area, premotor area, superior temporal gyrus and parietal lobe of the dominant hemisphere, which is consistent with the results in normal adults. Language lateralization was particularly useful in a case of meningioma in the left lateral ventricle and in a case of AVM in the left temporoparietal region. fMRI with shiritori tasks revealed right-hemisphere dominance in both cases, which was also confirmed by intracarotid amobarbital (Wada) testing. Both lesions were treated successfully without causing any further deficit to the patients' language function. These results suggest that fMRI with shiritori tasks can be used to assess language lateralization non-invasively, compared with the current techniques, such as intracarotid amobarbital testing and cortical electrostimulation mapping. Thus, fMRI with shiritori tasks has significant clinical potential as a presurgical evaluation tool. (author)

  19. Determination of language lateralization using functional MRI during the performance of shiritori tasks in neurosurgery patients

    Energy Technology Data Exchange (ETDEWEB)

    Takayama, Hideichi; Kobayashi, Masahito [Mihara Memorial Hospital, Isesaki, Gunma (Japan); Sugishita, Morihiro; Onozuka, Satoshi; Kawase, Takeshi

    2001-03-01

    Assessment of language lateralization is crucial in patients considered for neurological surgery. The authors used functional MRI (fMRI) in conjunction with shiritori, a kind of word-generation task as paradigms, to determine language lateralization in the patients. We used a 1.5 Tesla magnetic resonance imaging devise with an echo-planar imaging sequence. Thirty-two patients undergoing neurological surgery would alternately rest and silently perform shiritori during fMRI acquisition. Language lateralization was determined in 29 out of 32 patients. Twenty-two patients were considered as left-hemisphere dominant and seven were right-hemisphere dominant. Brain activation was seen in the prefrontal area, premotor area, superior temporal gyrus and parietal lobe of the dominant hemisphere, which is consistent with the results in normal adults. Language lateralization was particularly useful in a case of meningioma in the left lateral ventricle and in a case of AVM in the left temporoparietal region. fMRI with shiritori tasks revealed right-hemisphere dominance in both cases, which was also confirmed by intracarotid amobarbital (Wada) testing. Both lesions were treated successfully without causing any further deficit to the patients' language function. These results suggest that fMRI with shiritori tasks can be used to assess language lateralization non-invasively, compared with the current techniques, such as intracarotid amobarbital testing and cortical electrostimulation mapping. Thus, fMRI with shiritori tasks has significant clinical potential as a presurgical evaluation tool. (author)

  20. The clinical value of clonazepam in the wada test%氯硝西泮在Wada试验中的临床价值探讨

    Institute of Scientific and Technical Information of China (English)

    薛峰; 庄进学; 陈登奎; 周昌贵; 朱明霞; 陶传元; 宋朝理; 邓聪颖; 张炜

    2012-01-01

    目的 探讨氯硝西泮在Wada试验中的临床应用价值.方法 回顾分析我科自2006年7月至2010年6月,准备外科治疗的106例难治性颞叶癫痫患者,用氯硝西泮替代异戊巴比妥行Wada试验.结果 106例病人均未出现明显不良反应,测试后30分钟到60分钟均基本恢复到测试前意识水平.101例通过测试者行前颞叶切除术,其中3例术后出现短暂语言迟钝,经观察脱水治疗3~7天后逐渐恢复,其余病人术后均未出现明显的语言障碍及记忆功能缺失.结论 氯硝西泮在有效性、安全性上均达到临床用药要求,可以替代异戊巴比妥应用于Wada试验.%Objective To evaluate the clinical value of clonazepam replacing amobarbital in Wada test. Methods We retrospectively reviewed the clinical data of one hundred and six patients with medically intractable temporal epilepsy from July 2006 to June 2010 in our medical facility who underwent Wada test with clonazepam instead of amobarbital. Results There were no significant side effects in the 106 patients. After 30~60 minutes, all patients regained their pre— test conscious level. 101 cases of them passed the test and underwent anterior temporal lobecto-my. Except for three cases with temporary language barrier, the rest recovered without obvious a-phasia and amnesia. Conclusion Clonazepam can meet the clinical demands with regard to drug efficacy and safety in Wada test which is a suitable alternative to amobarbital.

  1. Solid-phase extraction and GC/MS confirmation of barbiturates from human urine.

    Science.gov (United States)

    Pocci, R; Dixit, V; Dixit, V M

    1992-01-01

    A highly selective and sensitive procedure has been developed for isolating and identifying barbiturates in human urine. With a new disposable bonded silica gel solid-phase extraction (SPE) column and hexobarbital as an internal standard (IS), amobarbital, butabarbital, pentobarbital, phenobarbital, secobarbital, and methaqualone were selectively isolated from endogenous urine components. Capillary gas chromatography/ion trap mass spectrometry (GC/MS) analysis of the extracts generated a full mass spectrum for the detection, identification, and quantitation of barbiturates. Linear quantitative response curves for the drugs have been generated over a concentration range of 20-500 ng/mL. Overall extraction efficiencies for drugs averaged greater than 90%, and the quantitative response curves exhibited correlation coefficients of 0.996 to 0.999. PMID:1353548

  2. Changes in bilateral bispectral index VISTA monitoring system during Wada test.

    Science.gov (United States)

    Pacreu, S; Vila, E; Rodríguez, C; Arroyo, R; Fernández, S; Fernández, J L

    2014-12-01

    The Wada test is a procedure used in the preoperative assessment before epilepsy surgery in order to determine language lateralization, to assess the post-operative risk of an amnesia syndrome, and to evaluate the risk of material-specific memory deficits, in particular verbal memory deficits. This test involves inserting a cannula into the internal carotid artery via the femoral artery, and then to inject amobarbital to shut down brain function, usually in one of the brain hemispheres. The bilateral bispectral index (BIS) VISTA™ monitoring system (BVMS) was used to detect changes in EEG, and in the power spectrum distribution using the density spectral array (DSA) of both hemispheres. We describe a patient with an agenesis of the A1 segment of the right anterior cerebral artery, scheduled for a Wada test, in whom the BVMS demonstrated its potential value. PMID:24657004

  3. Mesial temporal sclerosis: pathogenesis, diagnosis, and management.

    Science.gov (United States)

    Gates, J R; Cruz-Rodriguez, R

    1990-01-01

    Mesial temporal sclerosis (MTS) is probably the most common symptomatic pathologic entity--alone or mixed with other pathologic features--for seizures of temporal lobe origin. The pathophysiology of MTS, including any genetic influence, needs clarification. A characteristic ictal expression for seizures of MTS origin appears not to exist. The majority of patients (78%) with postresection MTS who are seizure-free have tightly localized interictal abnormalities restricted to F7/F8, Sp1/Sp2, T3/T4, and T5/T6 more than 96% of the time. MRI abnormalities may be seen in 55% of patients with MTS if both "hard" and "soft" criteria are used or in 20% when only "hard" criteria are used. The neuropsychologic evaluation of patients with MTS, which includes intracarotid amobarbital test (IAT), may prove to be increasingly useful in identifying patterns of cognitive deficit that correlate with enhancement of both lateralizing and localizing preoperative information. PMID:2226372

  4. Cardioprotection by modulation of mitochondrial respiration during ischemia–reperfusion: Role of apoptosis-inducing factor

    International Nuclear Information System (INIS)

    Highlights: •Blockade of electron transport prevents the loss of AIF from mitochondria during IR. •Blockade of electron transport decreases caspase-independent cell death during IR. •Mitochondrial AIF content is down-regulated in Harlequin mice. •Blockade of electron transport protects Harlequin mouse hearts during IR. •Amobarbital protection is partially dependent on mitochondrial AIF content. -- Abstract: The transient, reversible blockade of electron transport (BET) during ischemia or at the onset of reperfusion protects mitochondria and decreases cardiac injury. Apoptosis inducing factor (AIF) is located within the mitochondrial intermembrane space. A release of AIF from mitochondria into cytosol and nucleus triggers caspase-independent cell death. We asked if BET prevents the loss of AIF from mitochondria as a mechanism of protection in the buffer perfused heart. BET during ischemia with amobarbital, a rapidly reversible inhibitor of mitochondrial complex I, attenuated a release of AIF from mitochondria into cytosol, in turn decreasing the formation of cleaved and activated PARP-1. These results suggest that BET-mediated protection may occur through prevention of the loss of AIF from mitochondria during ischemia–reperfusion. In order to further clarify the role of mitochondrial AIF in BET-mediated protection, Harlequin (Hq) mice, a genetic model with mitochondrial AIF deficiency, were used to test whether BET could still decrease cell injury in Hq mouse hearts during reperfusion. BET during ischemia protected Hq mouse hearts against ischemia–reperfusion injury and improved mitochondrial function in these hearts during reperfusion. Thus, cardiac injury can still be decreased in the presence of down-regulated mitochondrial AIF content. Taken together, BET during ischemia protects both hearts with normal mitochondrial AIF content and hearts with mitochondrial AIF deficiency. Although preservation of mitochondrial AIF content plays a key role in

  5. Cardioprotection by modulation of mitochondrial respiration during ischemia–reperfusion: Role of apoptosis-inducing factor

    Energy Technology Data Exchange (ETDEWEB)

    Xu, Aijun [Department of Internal Medicine (Division of Cardiology), Virginia Commonwealth University, Richmond, VA 23298 (United States); Department of Anesthesiology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan 430030 (China); Szczepanek, Karol; Hu, Ying [Department of Internal Medicine (Division of Cardiology), Virginia Commonwealth University, Richmond, VA 23298 (United States); Lesnefsky, Edward J. [Department of Internal Medicine (Division of Cardiology), Virginia Commonwealth University, Richmond, VA 23298 (United States); Department of Biochemistry and Molecular Biology, Virginia Commonwealth University, Richmond, VA 23298 (United States); Department of Physiology and Biophysics, Virginia Commonwealth University, Richmond, VA 23298 (United States); McGuire Department of Veterans Affairs Medical Center, Richmond, VA 23249 (United States); Chen, Qun, E-mail: qchen8@vcu.edu [Department of Internal Medicine (Division of Cardiology), Virginia Commonwealth University, Richmond, VA 23298 (United States)

    2013-06-14

    Highlights: •Blockade of electron transport prevents the loss of AIF from mitochondria during IR. •Blockade of electron transport decreases caspase-independent cell death during IR. •Mitochondrial AIF content is down-regulated in Harlequin mice. •Blockade of electron transport protects Harlequin mouse hearts during IR. •Amobarbital protection is partially dependent on mitochondrial AIF content. -- Abstract: The transient, reversible blockade of electron transport (BET) during ischemia or at the onset of reperfusion protects mitochondria and decreases cardiac injury. Apoptosis inducing factor (AIF) is located within the mitochondrial intermembrane space. A release of AIF from mitochondria into cytosol and nucleus triggers caspase-independent cell death. We asked if BET prevents the loss of AIF from mitochondria as a mechanism of protection in the buffer perfused heart. BET during ischemia with amobarbital, a rapidly reversible inhibitor of mitochondrial complex I, attenuated a release of AIF from mitochondria into cytosol, in turn decreasing the formation of cleaved and activated PARP-1. These results suggest that BET-mediated protection may occur through prevention of the loss of AIF from mitochondria during ischemia–reperfusion. In order to further clarify the role of mitochondrial AIF in BET-mediated protection, Harlequin (Hq) mice, a genetic model with mitochondrial AIF deficiency, were used to test whether BET could still decrease cell injury in Hq mouse hearts during reperfusion. BET during ischemia protected Hq mouse hearts against ischemia–reperfusion injury and improved mitochondrial function in these hearts during reperfusion. Thus, cardiac injury can still be decreased in the presence of down-regulated mitochondrial AIF content. Taken together, BET during ischemia protects both hearts with normal mitochondrial AIF content and hearts with mitochondrial AIF deficiency. Although preservation of mitochondrial AIF content plays a key role in

  6. Isolating the segment of the mitochondrial electron transport chain responsible for mitochondrial damage during cardiac ischemia

    International Nuclear Information System (INIS)

    Ischemia damages the mitochondrial electron transport chain (ETC), mediated in part by damage generated by the mitochondria themselves. Mitochondrial damage resulting from ischemia, in turn, leads to cardiac injury during reperfusion. The goal of the present study was to localize the segment of the ETC that produces the ischemic mitochondrial damage. We tested if blockade of the proximal ETC at complex I differed from blockade distal in the chain at cytochrome oxidase. Isolated rabbit hearts were perfused for 15 min followed by 30 min stop-flow ischemia at 37 oC. Amobarbital (2.5 mM) or azide (5 mM) was used to block proximal (complex I) or distal (cytochrome oxidase) sites in the ETC. Time control hearts were buffer-perfused for 45 min. Subsarcolemmal mitochondria (SSM) and interfibrillar mitochondria (IFM) were isolated. Ischemia decreased cytochrome c content in SSM but not in IFM compared to time control. Blockade of electron transport at complex I preserved the cytochrome c content in SSM. In contrast, blockade of electron transport at cytochrome oxidase with azide did not retain cytochrome c in SSM during ischemia. Since blockade of electron transport at complex III also prevented cytochrome c loss during ischemia, the specific site that elicits mitochondrial damage during ischemia is likely located in the segment between complex III and cytochrome oxidase.

  7. Functional MRI and the Wada test provide complementary information for predicting post-operative seizure control.

    Science.gov (United States)

    Killgore, W D; Glosser, G; Casasanto, D J; French, J A; Alsop, D C; Detre, J A

    1999-12-01

    Prediction of post-surgical seizure relief and potential cognitive deficits secondary to anterior temporal lobectomy (ATL) are important to pre-surgical planning. Although the intracarotid amobarbital test (IAT) is predictive of post-ATL seizure outcome, development of non-invasive and more precise means for determining post-ATL seizure relief are needed. We previously reported on a technique utilizing functional MRI (fMRI) to evaluate the relative functional adequacy of mesial temporal lobe structures in preparation for ATL. In the present study, we report follow-up outcome data on eight temporal lobe epilepsy (TLE) patients 1-year post-ATL who were evaluated pre-surgically using IAT and fMRI. Functional memory lateralization using fMRI predicted post-ATL seizure outcome as effectively as the IAT. In general, asymmetry of functional mTL activation favouring the non-epileptic hemisphere was associated with seizure-free status at 1-year follow-up. Moreover, when combined, fMRI and IAT provided complementary data that resulted in improved prediction of post-operative seizure control compared with either procedure alone. PMID:10627406

  8. Comparison of mesial versus neocortical onset temporal lobe seizures: neurodiagnostic findings and surgical outcome.

    Science.gov (United States)

    Burgerman, R S; Sperling, M R; French, J A; Saykin, A J; O'Connor, M J

    1995-07-01

    We compared historical features, surface EEG findings, results of intracarotid sodium amobarbital memory testing (IAT), and outcome after anterotemporal lobectomy (ATL) in patients with mesiotemporal lobe seizure onset with those with more diffuse temporal lobe seizure onset (intracranial EEG). Forty-eight patients evaluated consecutively between July 1985 and October 1991 with both scalp/sphenoidal and intracranial EEG were shown to have seizures originating in one temporal lobe. No patients had temporal lobe tumor or vascular malformation. Thirty-seven of the 48 patients had seizure onset in the amygdala/hippocampus (amyg/hipp). Eleven of the 48 had either temporal neocortical onset or simultaneous amyg/hipp and neocortical onset. Patients with mesial onset seizures were more likely to have lateralized memory impairment on IAT (p = 0.05). We noted a trend toward a difference in age of first risk for epilepsy between the two groups (p = 0.09) but not for a difference in any specific risk factor. There were no significant differences in surface EEG interictal findings. Unlike in previous studies, comparison of outcome between the two groups showed no difference in seizure-free outcome. Sudden unexpected death (SUD) was more frequent in neocortical seizure patients who were not seizure-free (p < 0.05). PMID:7555982

  9. Sensitivity and specificity of asymmetric recall on WADA test to predict outcome after temporal lobectomy.

    Science.gov (United States)

    Lancman, M E; Benbadis, S; Geller, E; Morris, H H

    1998-02-01

    Some reports suggest that the intracarotid amobarbital test (IAT) is useful for predicting good seizure outcome after temporal lobectomy. The sensitivity, specificity, and predictive value of the IAT in this condition has not been previously studied. We designed this study to establish the value of memory recall asymmetry on the IAT as a predictor of outcome after temporal lobectomy. We studied memory recall on the IAT in 108 consecutive patients with intractable epilepsy who underwent presurgical evaluation for temporal lobectomy and had at least 1 year follow up after surgery. At a level of 30% asymmetry of recall, specificity for favorable outcome (Engel Class I and II) was 100% (95% confidence interval [CI], 85 to 100), sensitivity 51% (95% CI, 40 to 62), positive predictive value 100% (95% CI, 92 to 100), and negative predictive value 34% (95% CI, 23 to 47). At the same level of asymmetry, specificity for seizure-free outcome (Engel Class I) was 88% (95% CI, 68-95), sensitivity 37% (95% CI, 40 to 64), positive predictive value 87% (95% CI, 71 to 96), and negative predictive value 38% (95% CI, 27 to 50). Asymmetric recall on the IAT is highly specific but not very sensitive in predicting outcome after temporal lobectomy. PMID:9484371

  10. Effectiveness of four different clinical fMRI paradigms for preoperative regional determination of language lateralization in patients with brain tumors

    International Nuclear Information System (INIS)

    Blood oxygen level-dependent functional magnetic resonance imaging (fMRI) has demonstrated its capability to provide comparable results to gold standard intracarotid sodium amobarbital (Wada) testing for preoperative determination of language hemispheric dominance. However, thus far, no consensus has been established regarding which fMRI paradigms are the most effective for the determination of hemispheric language lateralization in specific categories of patients and specific regions of interest (ROIs). Forty-one brain tumor patients who performed four different language tasks - rhyming (R), silent word generation (SWG) sentence completion, and sentence listening comprehension (LC) - for presurgical language mapping by fMRI were included in this study. A statistical threshold-independent lateralization index (LI) was calculated and compared among the paradigms in four different ROIs for language activation: functional Broca's (BA) and Wernicke's areas (WA) as well as larger anatomically defined expressive (EA) and receptive (RA) areas. The two expressive paradigms evaluated in this study are very good lateralizing tasks in expressive language areas; specifically, a significantly higher mean LI value was noted for SWG (0.36 ± 0.25) compared to LC (0.16 ± 0.24, p = 0.009) and for R (0.40 ± 0.22) compared to LC (0.16 ± 0.24, p = 0.001) in BA. SWG LI (0.28 ± 0.19) was higher than LC LI (0.12 ± 0.16, p = 0.01) also in EA. No significant differences in LI were found among these paradigms in WA or RA. SWG and R are sufficient for the determination of lateralization in expressive language areas, whereas new semantic or receptive paradigms need to be designed for an improved assessment of lateralization in receptive language areas. (orig.)

  11. [Studies on the structure-activity relationship of allyl substituted oxopyrimidines searching for the novel antagonist or agonist of barbiturates to the sleep mechanism based on the uridine receptor theory--barbituric acid to uridine (part I)].

    Science.gov (United States)

    Yamamoto, Ikuo

    2005-01-01

    Thirty-six allyl substituted oxopyrimidine analogues such as barbituric acid (BA), barbiturates, uracil, thymine, and related derivatives including 13 new compounds were synthesized and their pharmacologic effects ([hypnotic activity, anticonvulsant activity against pentylentetrazol (PTZ)-induced seizures, and LD(50)]) and interactions with the barbiturates were evaluated in mice and rats. The results are briefly and parially summarized as follows. BA prolonged pentobarbital (PB)-induced sleep and had some central depressant effects. N,5,5-triallyl-BA exhibited some hypnotic and anticonvulsant activities, although the other 5,N-allyl-compounds did not show any activity except for allobarbital (AlloB). N-allyl-BA, 5-allyl-BA, N(1),N(3),5-triallyl-BA, N,5,5-triallyl-BA, and N(1),N(3),5,5-tetraallyl-BA also prolonged PB-induced sleep. Interestingly, N,5,5-triallyl-BA was the most potent in the interaction with AlloB, phenobarbital (PheB), amobarbital (AB), PB, and thiopental (TP) but not barbital (B). N(1),N(3),5,5-tetraallyl-BA prolonged AlloB-, PB-, and AB-induced sleep but not B-, PheB-, and TP-induced sleep. N(1),N(3),5-triallyl-B prolonged only PB- and TP-induced sleep. 5,5-diallyl-BA prolonged PheB- and TP-induced sleep. N,5-diallyl-BA prolonged only TP-induced sleep. In contrast, BA and N(1),N(3),5-triallyl-AB tended to antagonize AlloB, AB, and B. N(1),N(3),5,5-tetraallyl-BA also slightly antagonized B, PheB, and TP. 5,5-diallyl-BA antagonized only AB. The prolonging effects of BA, N,5,5-triallyl-BA, and N(1),N(3),5,5-tetraallyl-BA on PB-induced sleep were dose dependent. These results indicate that the position and number of allyl groups substituted on the structure of BA play an important role in their depressant activities. This review deals with the structure-activity relationship of allyl-substituted oxopyrimidines as part of our search for antagonists and agonists of barbiturates as well as their mechanisms of action. PMID:15635282

  12. A study of the risk of mental retardation among children of pregnant women who have attempted suicide by means of a drug overdose

    Directory of Open Access Journals (Sweden)

    Andrew E. Czeizel

    2012-01-01

    Full Text Available BACKGROUND: The aim of the study was to estimate the effect on the fetal development of high doses of prescription drugs taken as a suicide attempt during pregnancy. METHODS: Pregnant women were identified among self-poisoned females in the toxicological inpatient clinic in Budapest between 1960 and 1993. Congenital abnormalities, intrauterine development based on birth weight and post-conceptional age, mental retardation, cognitive-behavioral status were compared in exposed children born to mothers who had attempted suicide by means of a drug overdose during pregnancy with their siblings, born either before or after the affected pregnancy, as sib controls. RESULTS: Of a total of 1 044 pregnant women, 74 used the combination of amobarbital, glutethimide and promethazine (Tardyl®, one of the most popular drugs for treatment of insomnia in Hungary for suicide attempt. Of these 74 women, 27 delivered live-born babies. The mean dose of Tardyl® used for suicide attempts was 24 times the usually prescribed clinical dose. The rate of congenital abnormalities and intrauterine retardation was not higher in exposed children than in their sib controls. However, of the 27 exposed children, eight (29.6% were mentally retarded (Χ21=79.7, p= Sig while mental retardation did not occur among 46 sib controls. These exposed children were born to mothers who attempted suicide with Tardyl® between the 14th and 20th post-conceptional weeks. The components of Tardyl® used separately for a suicide attempt during pregnancy were not associated with a higher risk of mental retardation. Therefore the high doses of Tardyl® associated with the high risk for mental retardation may be due to the interaction of its three drug components. CONCLUSIONS: The findings of the study showed that the high doses of a drug containing three components may be associated with a significantly increased risk for mental retardation without any structural defects, whereas each of these

  13. 高压氧防止创伤/失血性休克复苏后大鼠肠道缺血-再灌注损伤%Hyperbaric oxygen prevents intestinal ischemia-reperfusion injury in rats after resuscitation from traumatic/hemorrhagic shock

    Institute of Scientific and Technical Information of China (English)

    金立方; 王为成; 王钢

    2009-01-01

    目的 观察高压氧(HBO)对创伤/失血性休克复苏后大鼠肠道缺血-再灌注损伤的保护作用并探讨其作用机制.方法Wistar大鼠用铁块砸击左侧股骨并同时通过右颈动脉放血建立创伤/失血性休克模型,随后进行自体血和液体复苏.大鼠随机分成对照组、休克组、HBO一次和三次治疗组.结果 复苏24 h后HBO一次和三次组大鼠肠道组织乳酸含量、诱生型一氧化氮合成酶(iN0s)活性、一氧化氮(NO)和肿瘤坏死因子-α(TNF-α)水平均明显低于休克组(P0.05).结论HBO可以减少创伤性休克后肠道组织炎性细胞因子的产生,减轻炎症反应,保护肠道组织和黏膜屏障免受创伤/失血性休克后缺血/再灌注的损伤.%Objective To investigate the effects of hyperbaric oxygen (HBO) on ischemia/repeffusion (Ⅰ/R) injury of the small intestine after resuscitation from trauma and hemorrhagic shock (T/HS) in rats in order to elucidate the underlying mechanisms. Method Ninety-six male Wistar rats were randomly divided into four groups with 24 rats in each group. In shock group, rats were operated with induced T/HS. In sham group, rats operated without induced T/HS. In one HBO therapy (HBOT) group, rats with T/HS were treated with HBOT once. In three-HBOT group, rats with T/HS were treated with HBOT thrice. The Animal Care and Use Committee of China Medical University approved all animal protocols. Rats were anesthetized with amobarbital sodium (80 mg/kg, i.p.) at room temperature (25 ℃), the bloed pressure was monitored via polyethylene cannula inserted into the right femoral artery, connecting with the pressure analyzer (Multiparameter Monitor, M3046A, Boebin-gen, Germany). The left jugular vein was cannulated for administering normal saline and for resuscitation. The right carotid artery was cannulated for shedding blood. After operation, the middle part of left thigh of rat was se-lected as a site to be made of trauma by a lump of 2.5 kg iron