Biomedical subjects

M-C Pai

Publications and source records attributed to M-C Pai.

3 recordsLinked to original sources

PubMed2005

Cognitive performance in cryptogenic epilepsy.

Cognitive impairment in epilepsy has begun to gain more attention in clinical practice. There is now a considerable amount of research relating to memory functioning in epilepsy, however, few studies specifically focused on cryptogenic epilepsy. We investigated the cognitive performance in cryptogenic epilepsy patients with the aid of cognitive ability screening instrument (CASI), based on cross-sectional and longitudinal aspects. A total of 100 patients who met the diagnostic criteria of cryptogenic epilepsy were recruited from a national university hospital. The patients with normal CASI scores were compared with those with abnormal ones. We also compared the follow-up CASI score after 3 years with the previous score in all cryptogenic epilepsy patients. Thirty-six per cent of cryptogenic epilepsy patients showed cognitive impairment. The variables correlated with higher risks of cognitive impairment were lower educational status, number of seizure types, duration of seizure and polytherapy, especially in the lower educational status. The correlation between CASI and the Mini-Mental State Examination was excellent. In the follow-up study, the abnormal group showed significant improvement in total CASI score. The normal group showed no significant change. We suggest that in cryptogenic epilepsy, lower educational status remains the most important factor in determining cognitive performance. Adequate treatment with antiepileptic drugs can improve cognitive performance in previously cognitively impaired patients.

Adult↗

PubMed2003

Central neurological abnormalities and multiple chemical sensitivity caused by chronic toluene exposure.

Multiple chemical sensitivity (MCS) is a syndrome in which multiple symptoms occur with low-level chemical exposure; whether it is an organic disease initiated by environmental exposure or a psychological disorder is still controversial. We report a 38-year-old male worker with chronic toluene exposure who developed symptoms such as palpitation, insomnia, dizziness with headache, memory impairment, euphoria while working, and depression during the weekend. Upon cessation of exposure, follow-up neurobehavioural tests, including the cognitive ability screening instrument and the mini-mental state examination, gradually improved and eventually became normal. Although no further toluene exposure was noted, non-specific symptoms reappeared whenever the subject smelled automotive exhaust fumes or paint, or visited a petrol station, followed by anxiety with sleep disturbance. During hospitalization for a toluene provocation test, there was no difference between pre-challenge and post-challenge PaCO(2), PaO(2), SaO(2) or pulmonary function tests, except some elevation of pulse rate. The clinical manifestations suggested that MCS was more relevant to psychophysiological than pathophysiological factors.

Adult↗

PubMed2002

Flow resistance in carotid and middle cerebral arteries in postmenopausal women: a comparative study of tibolone and continuous combined hormone replacement therapy.

OBJECTIVE: The study sought to compare the vascular resistance and serum lipids of postmenopausal women assigned to tibolone therapy or continuous combined hormone replacement therapy. DESIGN: This was a 6-month, prospective, single-blind, single-center, randomized study. A total of 50 healthy postmenopausal women were enrolled. At study end, 40 women had completed a 6-month follow-up. The first group (23 subjects) received conjugated equine estrogens (CEE) 0.625 mg/day and medroxyprogesterone acetate (MPA) 5 mg/day. The second group (17 subjects) received tibolone 2.5 mg/day. The pulsatility and resistance indexes of the carotid and middle cerebral arteries, and serum lipid profiles were monitored. RESULTS: Comparisons demonstrated that there were no significant differences between the groups in terms of changes in the pulsatility index (PI) and the resistance index (RI) of the common carotid artery (CCA), internal carotid artery (ICA), and middle cerebral artery (MCA) within the study period. Both treatments effectively reduced the total cholesterol level and with no significant differences found between the two regimens. However, in comparing the two groups, we found that high-density lipoprotein (HDL) cholesterol levels were significantly lower in the tibolone group at either 3 months or 6 months after treatment, whereas a significantly higher triglycerides level was observed in the CEE + MPA group after 3 months of treatment. Low-density lipoprotein (LDL) cholesterol levels indicated no significant differences between the two groups after treatment. CONCLUSIONS: The study demonstrated that major neck and cerebral vascular impedance was not influenced significantly by either regimen. Nonetheless, lipid profiles were affected differently by tibolone and by continuous combined CEE + MPA. However, whether or not these findings might modify cardiovascular risk is still unknown.

Blood Flow Velocity↗