Public health genetics - experiences and challenges.
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Chronically implanted depth and subdural electrodes have both been shown to be satisfactory means of localizing epileptogenic foci. Utilizing bilateral mesial temporal depth electrodes, we have localized mesial temporal foci in a large percentage of patients. Depth electrode investigation of a more limited number of patients with suspected extramesial temporal foci has not been as reliable in giving localizing information. We have more recently used subdural electrodes to investigate this latter category of patients, and preliminary findings suggest that this technique may be of localizing value in several subcategories.
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Eight patients with epidermolysis bullosa received a total of 60 anaesthetics for 67 procedures over the fifteen-year period 1972 to 1986. On twenty-three occasions patients were intubated. On thirteen occasions general anaesthesia was supplemented by regional blockade, involving a total of thirty-four local anaesthetic blocks. Complications from intubation were minimal and none were seen related to regional blockade.
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This article reviews the relationship of oxidative stress with nucleoside reverse transcriptase inhibitor (NRTI)-induced toxicity and suggests how oxi-dative stress may participate in NRTI-mediated toxicity. NRTIs are pro-drugs that require intracellular phosphorylation to their 5' triphosphates by cellular kinases to inhibit viral and mitochondrial DNA (mtDNA) replication. NRTIs in highly active antiretroviral therapy have decreased morbidity and mortality, but side effects can be limiting after prolonged use. These side effects may be linked through mitochondrial dysfunction arising from altered mtDNA replication and oxidative stress via destruction of elements of mtDNA replication, decreased oxidative phosphorylation, and cellular function. Although oxidative stress is associated with NRTI therapy, there is still debate about whether it plays a direct role in NRTI-induced toxicity. The impact of oxidative stress on cardiovascular disease is likely to increase because patients with HIV infection are living longer as a result of effective antiretroviral therapy.
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