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Ultrafast x-ray photoelectron diffraction (UXPD) for free molecules has a promising potential to probe the local structures of the molecules in an element-specific fashion. Our UXPD scheme consists of three steps: (1) near-infrared laser (NIR) with ns pulse duration aligns sample molecules, (2) ultra-violet laser with fs pulse duration pumps the aligned molecules, and (3) soft x-ray free-electron laser (SXFEL) with fs pulse duration probes the molecules by measuring x-ray photoelectron diffraction (XPD) profiles. Employing steps of (1) and (3), we have measured I 3d XPD profiles from ground state iodobenzene aligned by the NIR laser with the SXFEL. Then, we have intensively calculated I 3d XPD profiles with density functional theory, taking degrees of alignments of the molecules into account, to extract a distance between C and I atoms in iodobenzene from the experimental I 3d XPD profiles. Although we have failed to determine the distance from the comparison between the experimental and theoretical results, we have succeeded in concluding that the degeneracies of the initial state eliminate the sensitivity on molecular structure in the I 3d XPD profiles. Thus, the observation of fine structures in the XPD profiles could be expected, if a nondegenerate molecular orbital is selected for a probe of UXPD. Finally, we have summarized our criteria to perform UXPD successfully: (1) to use SXFEL, (2) to prepare sample molecules with the degree of alignment higher than 0.8, and (3) to select a photoemission process from a nondegenerate inner-shell orbital of sample molecules.
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F1s and C1s photoelectron angular distributions are considered for CH3F, a molecule which does not support any shape resonance. In spite of the absence of features in the photoionization cross section profile, the recoil frame photoelectron angular distributions (RFPADs) exhibits dramatic changes depending on both the photoelectron energy and polarization geometry. Time-dependent density functional theory calculations are also given to rationalize the photoionization dynamics. The RFPADs have been compared with the theoretical calculations, in order to assess the accuracy of the theoretical method and rationalize the experimental findings. The effect of finite acceptance angles for both ionic fragments and photoelectrons has been included in the calculations, as well as the effect of rotational averaging around the fragmentation axis. Excellent agreement between theory and experiment is obtained, confirming the good quality of the calculated dynamical quantities (dipole moments and phase shifts).
Assuntos
Hidrocarbonetos Fluorados/química , Processos Fotoquímicos , Carbono/química , Proteínas de Ligação a DNA , Flúor/química , Íons/química , Modelos Químicos , ProteínasRESUMO
Strictures remaining after nonsurgical treatment for esophageal cancer are generally more refractory to endoscopic balloon dilation (EBD) when compared with anastomotic strictures. The aim of the present study was to evaluate the efficacy and safety of a radial incision and cutting (RIC) method for the treatment of refractory strictures after nonsurgical treatment of esophageal cancer. All subjects complained of grade 2 or worse dysphagia, even after at least 10 sessions of EBD. Between August 2009 and May 2012, eight consecutive patients with refractory esophageal stricture after nonsurgical treatments, including chemoradiotherapy (CRT) alone (n = 3), CRT followed by salvage endoscopic treatment (n = 3), or endoscopic submucosal dissection (ESD; n = 2), underwent the RIC procedure. After the RIC procedure, dysphagia in all the patients dramatically improved to grade 1 or 0 without any major complications; however, the long-term efficacy was unfavorable as only 37.5 % (3 /8) demonstrated adequate lumen patency at 3 months, and re-intervention was necessary in six patients (75 %).
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Transtornos de Deglutição/cirurgia , Neoplasias Esofágicas/terapia , Estenose Esofágica/etiologia , Estenose Esofágica/cirurgia , Idoso , Quimiorradioterapia/efeitos adversos , Transtornos de Deglutição/etiologia , Dilatação , Estenose Esofágica/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Fotoquimioterapia/efeitos adversosRESUMO
We have measured the angular correlation between the B K-VV Auger electrons of BF(3) molecules and the coincident fragment-ion pairs of BF(2)(+)-F(+). Then, we have found that the measured angular correlation patterns depending on the mutual angle between the light polarization direction and molecular orientation are affected by the anisotropic axis distribution of the molecular ensemble of BF(3)(+) reflecting the anisotropic nature of photon-molecule interaction. In this context, we have pointed out generally that for coincidence experiments, so-called molecular frame Auger electron angular distributions are realized only if the axis distribution of the molecular ion ensemble is isotropic.
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Recoil frame photoelectron angular distributions (RFPADs) of BF(3) molecules are presented over the energy region of the shape resonance in the F 1s continuum. Time-dependent density functional theory calculations are also given to understand the shape resonance dynamics. The RFPADs have been compared with the theoretical calculations. It is found that the RFPADs calculated by the localized core-hole model are in better agreement with the experimental, compared with those by the delocalized core hole. Dipole matrix elements and dipole prepared continuum wavefunctions show that the shape resonance in the F 1s ionization continuum of BF(3) is induced by p-partial waves as previously reported by Swanson et al. [J. Chem. Phys. 75, 619 (1981)]. However, due to the couplings with the other partial waves the feature characteristic of the p-partial waves has not been observed in the RFPADs.
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Boranos/química , Elétrons , Modelos TeóricosRESUMO
The dynamic behavior and kinetics of the structural transformation of supported bimetallic nanoparticle catalysts with synergistic functions in the oxidation process are fundamental issues to understand their unique catalytic properties as well as to regulate the catalytic capability of alloy nanoparticles. The phase separation and structural transformation of Pt(3)Sn/C and PtSn/C catalysts during the oxidation process were characterized by in situ time-resolved energy-dispersive XAFS (DXAFS) and quick XAFS (QXAFS) techniques, which are element-selective spectroscopies, at the Pt L(III)-edge and the Sn K-edge. The time-resolved XAFS techniques provided the kinetics of the change in structures and oxidation states of the bimetallic nanoparticles on carbon surfaces. The kinetic parameters and mechanisms for the oxidation of the Pt(3)Sn/C and PtSn/C catalysts were determined by time-resolved XAFS techniques. The oxidation of Pt to PtO in Pt(3)Sn/C proceeded via two successive processes, while the oxidation of Sn to SnO(2) in Pt(3)Sn/C proceeded as a one step process. The rate constant for the fast Pt oxidation, which was completed in 3 s at 573 K, was the same as that for the Sn oxidation, and the following slow Pt oxidation rate was one fifth of that for the first Pt oxidation process. The rate constant and activation energy for the Sn oxidation in PtSn/C were similar to those for the Sn oxidation in Pt(3)Sn/C. In the PtSn/C, however, it was hard for Pt oxidation to PtO to proceed at 573 K, where Pt oxidation was strongly affected by the quantity of Sn in the alloy nanoparticles due to swift segregation of SnO(2) nanoparticles/layers on the Pt nanoparticles. The mechanisms for the phase separation and structure transformation in the Pt(3)Sn/C and PtSn/C catalysts are also discussed on the basis of the structural kinetics of the catalysts themselves determined by the in situ time-resolved DXAFS and QXAFS.
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Photodetachment of the positronium negative ion, a bound state of one positron and two electrons, has been observed. Development of a method to produce the ions efficiently using a Na coated tungsten surface has enabled the first observation of the photodetachment. The obtained lower limit of the photodetachment cross section for the wavelength of 1064 nm is consistent with the theoretical calculations reported so far. The experimental field developed in the present work gives new opportunities to explore the quantum mechanical three-body problem and to develop energy-tunable positronium beams.
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Benzene and fluorobenzene molecules were multiply ionized through Auger decay following from the C 1s or the F 1s photoionization and their subsequent dissociations were studied utilizing position-sensitive time-of-flight measurements. The angular correlation between the momenta of (H(+)-H(+)) and (H(+)-F(+)) fragment ions derived from the multiply ionized benzene or fluorobenzene clearly reflects the hexagonal structure of the parent molecules, though the dissociations are not described by the simple Coulomb explosion model. Also, analysis on the planarity between the momentum of H(+), C(+), and F(+) reveals that these three ions are emitted almost in a single plane.
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INTRODUCTION: Ganglioglioma is an uncommon neoplasm of the central nervous system, most frequently seen in the temporal lobe, and usually associated with medically refractory epilepsy in children and young adults. Few reports have considered ganglioglioma-associated epileptogenicity arising in the temporal lobe. The purpose of our study was to define the imaging features of ganglioglioma in the temporal lobe and their relation to the seizure foci revealed by electrocorticograms. MATERIALS AND METHODS: We reviewed 24 patients with pathologically confirmed ganglioglioma in the temporal lobe. RESULTS: Computed tomography (CT) images showed gangliogliomas to be isodense (91.7%), and on T1-weighted images (T1-WI) most gangliogliomas (79.2%) were isointense to the gray matter. A cystic lesion was seen in 14 of 24 of the gangliogliomas (58.3%). Mass effects were not seen in any of the ten tumors without cystic components. One patient showed tumor recurrence. Dual pathology was seen in two cases (8.3%). In 23 cases, epileptogenicity was confirmed in the tumors by intraoperative electrocorticogram. The remaining case had no epileptogenicity. CONCLUSION: A tumor presenting isointensity to gray matter on T1-WI without mass effects in the medial temporal lobe in a young patient with temporal lobe epilepsy (TLE) might be the characteristic imaging of temporal lobe ganglioglioma. However, such tumors are not always associated with epileptogenicity, even if a ganglioglioma is found in a patient with TLE. The seizure foci may be contralateral to the ganglioglioma. Therefore, we need to investigate the hippocampus, white matter abnormalities of the ipsilateral and contralateral anterior temporal lobe, and other focal lesions closely.
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Neoplasias Encefálicas/complicações , Neoplasias Encefálicas/patologia , Epilepsia do Lobo Temporal/etiologia , Epilepsia do Lobo Temporal/patologia , Ganglioglioma/complicações , Ganglioglioma/patologia , Lobo Temporal/patologia , Adolescente , Adulto , Neoplasias Encefálicas/cirurgia , Criança , Pré-Escolar , Meios de Contraste , Epilepsia do Lobo Temporal/cirurgia , Feminino , Ganglioglioma/cirurgia , Humanos , Lactente , Imageamento por Ressonância Magnética , Masculino , Tomografia Computadorizada por Raios XRESUMO
BACKGROUND AND PURPOSE: In hemimegalencephaly, MR imaging often reveals midsagittal bandlike structures between the 2 lateral ventricles. To determine whether these structures are aberrant midsagittal fibers, we retrospectively reviewed them on conventional MR imaging and prospectively examined them by diffusion tensor MR and fiber tract (FT) reconstruction imaging. MATERIALS AND METHODS: We retrospectively reviewed conventional MR images of 26 consecutive patients with hemimegalencephaly by 2 neuroradiologists, focusing on abnormal midsagittal structures. The distance between the 2 anterior horns and widths of midsagittal bandlike structures were measured. Prospective analysis was performed in 7 consecutive patients with hemimegalencephaly examined for midsagittal aberrant fibers by diffusion tensor imaging, and cortical distribution areas of the fibers were observed. RESULTS: The distance between the 2 anterior horns was wide (>4 mm) due to white matter-intensity structures in 20 of 26 patients (76.9%). Mid-sagittal bandlike structures were observed in 15 patients (57.7%). Asymmetry of the fornices was detected in 7 patients (26.9%), and both fornices were thickened in 7 (26.9%) patients. On FT reconstruction, images showed that 4 of 7 patients with hemimegalencephaly had aberrant midsagittal fibers connecting frontal, occipital, or parietal lobes, bilaterally (n = 3) or ipsilaterally (n = 1). All 4 patients had increased width between the 2 anterior horns, and 3 of them exhibited midsagittal bandlike structures on conventional MR imaging. On the other hand, these MR imaging findings were not noted in 3 patients who did not have aberrant midsagittal fibers on diffusion tensor imaging. CONCLUSIONS: Aberrant midsagittal FTs running intra- or interhemispherically do not infrequently exist in patients with hemimegalencephaly.
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Encéfalo/patologia , Imageamento por Ressonância Magnética , Malformações do Desenvolvimento Cortical/patologia , Adolescente , Adulto , Ventrículos Cerebrais/patologia , Criança , Pré-Escolar , Corpo Caloso/patologia , Imagem de Difusão por Ressonância Magnética , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Lactente , MasculinoRESUMO
BACKGROUND AND PURPOSE: Our aim was to clarify imaging findings of amyotrophic lateral sclerosis with dementia (ALSD). MATERIALS AND METHODS: T2-weighted MR images (T2WI) of 3 patients with ALSD (2 men, 1 woman; 58-71 years of age) and 21 patients with ALS without dementia (12 men, 9 women; 46-74 years of age) were examined for frontotemporal lobar atrophy and signal-intensity alterations in the white matter of the anterior temporal lobes, corticospinal tracts (CST), and precentral gyri and in precentral cortices. The brain of one of the patients with ALSD was examined at autopsy. RESULTS: All patients with ALSD showed bilateral frontotemporal atrophy mostly with temporal lobe dominance. In the ALSD group, T2WI demonstrated hyperintensity in the subcortical white matter on the medial side of the anterior temporal lobes, whereas in the group without dementia, none showed this imaging finding. MR images demonstrated no abnormal signal-intensity changes in CST in the internal capsule or the brain stem in the ALSD group. In the group without dementia, 6 patients (28.6%) showed this imaging finding. In neuropathologic examinations of the brain of 1 patient with ALSD, myelin-stained sections of the brain demonstrated loss of myelin in the subcortical white matter on the medial side of the anterior temporal white matter. CONCLUSIONS: A symmetric pattern of frontotemporal atrophy and anteromedial subcortical hyperintensities in the temporal lobes on T2WI could be characteristic of ALSD.
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Esclerose Lateral Amiotrófica/diagnóstico , Imageamento por Ressonância Magnética , Lobo Temporal/patologia , Idoso , Esclerose Lateral Amiotrófica/patologia , Atrofia , Feminino , Lobo Frontal/patologia , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
BACKGROUND AND PURPOSE: Hemimegalencephaly is a rare but well-known congenital malformation with ipsilateral enlargement of the hemicerebrum. However, very little is known about changes in structures outside the involved hemisphere in patients with this condition. We investigated morphologic abnormalities occurring outside the affected hemisphere by MR imaging in a large series of patients with hemimegalencephaly. MATERIALS AND METHODS: MR imaging findings for 30 patients with hemimegalencephaly were retrospectively reviewed and evaluated for structures outside the involved hemisphere on routine MR images, such as cranial nerves (I, II, V), brain vessels, subdural and subarachnoid spaces, brain stem, and cerebellum, on both the ipsilateral and contralateral sides. RESULTS: The ipsilateral olfactory and optic nerves were enlarged in 8 (26.7%) and 1 (3.3%) of the 30 patients, respectively, without enlargement on the contralateral side. No asymmetry was noted in the trigeminal nerves. Asymmetric vascular dilations in the ipsilateral cerebral hemisphere were observed in 12 of the 30 patients (40%), in deep cerebral vessels in 11 patients (36.7%), and in superficial cerebral vessels in 8 patients (26.7%). Ipsilateral brain stem and hemicerebellar asymmetric enlargement was detected in 2 patients (6.7%) and 14 patients (46.7%), respectively. Abnormal cerebellar folia were observed on the ipsilateral side in 6 patients (20%) and on the contralateral side in 3 patients (10%). CONCLUSION: Ipsilateral olfactory nerve enlargement, cerebral vascular dilations, cerebellar enlargement, and bilateral or ipsilateral abnormal architecture of the cerebellar folia are often associated with hemimegalencephaly.
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Encéfalo/anormalidades , Adolescente , Adulto , Criança , Pré-Escolar , Nervos Cranianos/anormalidades , Epilepsia/patologia , Feminino , Humanos , Lactente , Imageamento por Ressonância Magnética , MasculinoRESUMO
We report 2 cases of intraspinal germinoma associated with Klinefelter syndrome. In one patient, spinal cord atrophy was observed at the upper and lower ends of the intraspinal tumor. Brain atrophy was observed in both cases. Germinoma should be included in the differential diagnosis if an intraspinal tumor is observed in a patient with Klinefelter syndrome.
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Germinoma/complicações , Síndrome de Klinefelter/complicações , Neoplasias da Medula Espinal/complicações , Adulto , Encéfalo/patologia , Germinoma/diagnóstico , Germinoma/patologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Neoplasias da Medula Espinal/diagnóstico , Neoplasias da Medula Espinal/patologia , Vértebras TorácicasRESUMO
INTRODUCTION: White matter abnormalities in the anterior temporal lobe (WAATL) are sometimes observed on magnetic resonance (MR) images of patients with temporal lobe epilepsy (TLE). Our purpose was to determine whether WAATL could indicate if the seizure foci are ipsilateral on electroencephalograms (EEG) in TLE patients. METHODS: We reviewed 112 consecutive patients with medically intractable TLE. We compared the side of seizure foci on EEG (preoperative and intraoperative) and MR images. RESULTS: Both loss of gray-white matter demarcation and increased signal intensity changes in the anterior white matter (positive WAATL) were observed in 54 of 112 patients (48.2%) with TLE. WAATL were present on the same side as the seizure foci on preoperative intracranial EEG with subdural electrodes (iEEG) and on intraoperative electrocorticography (ECG) in all the patients. In 47 patients, MR images showed WAATL and focal lesions that were possibly epileptogenic for TLE. In 2 of the 47 patients, the seizure foci on iEEG and ECG were contralateral to the focal lesion; in the remaining 45 patients, the seizure foci on surface EEG (sEEG) and ECG and the focal lesion were on the same side. In three patients, no focal lesions were seen but WAATL were present on the same side as the seizure foci on sEEG and ECG. In four patients, MR images showed focal lesions for which epileptogenicity was questionable, and WAATL on the same side as the seizure foci on EEG. CONCLUSION: WAATL are clinically useful because they indicate the side of the seizure foci.
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Epilepsia do Lobo Temporal/patologia , Epilepsia do Lobo Temporal/fisiopatologia , Lobo Temporal/patologia , Adolescente , Adulto , Criança , Pré-Escolar , Eletroencefalografia , Epilepsia do Lobo Temporal/cirurgia , Feminino , Humanos , Lactente , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Lobo Temporal/fisiopatologiaRESUMO
We report a case of pantothenate kinase-associated neurodegeneration with increased regional cerebral blood flow (rCBF) in bilateral lentiform nuclei on technetium Tc-99m ethyl cysteinate dimer single-photon emission CT (ECD-SPECT). A 6-year-old boy presented with opisthotonus. T2*-weighted MR images revealed areas of marked hypointensity with a hyperintense focus in bilateral globus pallidus, creating the characteristic eye-of-the-tiger appearance. ECD-SPECT showed increased rCBF in bilateral lentiform nuclei.
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Encéfalo/diagnóstico por imagem , Corpo Estriado/irrigação sanguínea , Degeneração Neural/diagnóstico por imagem , Neurodegeneração Associada a Pantotenato-Quinase/diagnóstico por imagem , Fosfotransferases (Aceptor do Grupo Álcool)/genética , Encéfalo/patologia , Circulação Cerebrovascular , Criança , Corpo Estriado/diagnóstico por imagem , Cisteína/análogos & derivados , Humanos , Imageamento por Ressonância Magnética , Masculino , Mutação , Compostos de Organotecnécio , Neurodegeneração Associada a Pantotenato-Quinase/diagnóstico , Neurodegeneração Associada a Pantotenato-Quinase/genética , Neurodegeneração Associada a Pantotenato-Quinase/fisiopatologia , Compostos Radiofarmacêuticos , Tomografia Computadorizada de Emissão de Fóton ÚnicoRESUMO
OBJECTIVE: To evaluate the area of the midbrain and pons on mid-sagittal MRI in patients with progressive supranuclear palsy (PSP), Parkinson disease (PD), and multiple-system atrophy of the Parkinson type (MSA-P), compare these appearances and values with those of normal control subjects, and establish diagnostic MRI criteria for the diagnosis of PSP. METHODS: The authors prospectively studied MRI of 21 patients with PSP, 23 patients with PD, 25 patients with MSA-P, and 31 age-matched normal control subjects. The areas of the midbrain tegmentum and the pons were measured on mid-sagittal MRI using the display tools of a workstation. The ratio of the area of the midbrain to the area of the pons was also evaluated in all subjects. RESULTS: The average midbrain area of the patients with PSP (56.0 mm2) was significantly smaller than that of the patients with PD (103.0 mm2) and MSA-P (97.2 mm2) and that of the age-matched control group (117.7 mm2). The values of the area of the midbrain showed no overlap between patients with PSP and patients with PD or normal control subjects. However, patients with MSA-P showed some overlap of the values of individual areas with values from patients with PSP. The ratio of the area of the midbrain to the area of pons in the patients with PSP (0.124) was significantly smaller than that in those with PD (0.208) and MSA-P (0.266) and in normal control subjects (0.237). Use of the ratio allowed differentiation between the PSP group and the MSA-P group. CONCLUSION: The area of the midbrain on mid-sagittal MRI can differentiate PSP from PD, MSA-P, and normal aging.
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Tronco Encefálico/patologia , Imageamento por Ressonância Magnética/métodos , Mesencéfalo/patologia , Ponte/patologia , Paralisia Supranuclear Progressiva/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/patologia , Atrofia/diagnóstico , Atrofia/etiologia , Diagnóstico Diferencial , Erros de Diagnóstico/prevenção & controle , Feminino , Humanos , Processamento de Imagem Assistida por Computador/métodos , Masculino , Pessoa de Meia-Idade , Atrofia de Múltiplos Sistemas/diagnóstico , Doença de Parkinson/diagnóstico , Valor Preditivo dos Testes , Estudos Prospectivos , Reprodutibilidade dos TestesRESUMO
Angular distributions of C 1s photoelectrons from fixed-in-space CO molecules have been measured with vibrational resolution. A strong dependence of the angular distributions on the vibrational states of the residual molecular ion has been found for the first time in the region of the shape resonance. Calculations in the relaxed core Hartree-Fock approximation have reproduced the angular distributions fairly well in the general shapes of the angular distributions due to the correct description of nuclear motion as an average of the internuclear-distance-dependent dipole amplitudes.
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Angular distributions of photoelectrons from a 2sigma(g) shell of fixed-in-space N2 molecules have been measured for left- and right-elliptically polarized and for linearly polarized light at several photon energies in the region of sigma(*) shape resonance. That allowed the determination of a set of dipole matrix elements and phase shift differences characterizing the process. These data clearly show the enhancement of the fsigma(u) partial cross section in the resonance simultaneously with an abrupt increase of the corresponding phase shift by pi, which is the first experimental demonstration of the nature of the sigma(*) shape resonance in homonuclear diatomic molecules.
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A 72-year-old man presented with paroxysmal and transient involuntary movements, or "limb shaking". The attacks occurred alternately from one side of the body to the other and ceased spontaneously. Surface EMG study showed synchronous grouping discharges in multiple limb muscles, being compatible with hemiballism-hemichorea. Cerebral angiography demonstrated marked stenosis of the bilateral internal carotid arteries. Bilateral carotid endarterectomy led to complete disappearance of the involuntary movements. Alternating paroxysmal hemiballismhemichorea might be a transient ischemic attack, and alternating striatal dysfunction induced by cerebral hemodynamic or microembolic ischemia probably plays a central role in the occurrence of such involuntary movements.
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Artéria Carótida Interna , Estenose das Carótidas/complicações , Coreia/etiologia , Discinesias/etiologia , Idoso , Angiografia , Artéria Carótida Interna/patologia , Artéria Carótida Interna/cirurgia , Estenose das Carótidas/cirurgia , Coreia/diagnóstico , Discinesias/diagnóstico , Eletromiografia , Endarterectomia das Carótidas , Humanos , Imageamento por Ressonância Magnética , Masculino , Tomografia Computadorizada de Emissão de Fóton ÚnicoRESUMO
We report here a 12-year-old patient with unilateral cortical dysgenesis and intractable simple partial seizure in his left arm, who underwent multiple subpial transection (MST) in the right cerebral cortex including the primary motor cortex. We investigated motor cortical excitability using multimodal transcranial magnetic stimulation (TMS) before and 1 month after MST, in which surgical cortical incisions were made with strokes 5 mm apart and 4 mm deep. Preoperative TMS studies showed hyperexcitability in the affected motor cortex as abnormally prolonged muscle responses to TMS with a wide cortical motor map, which were markedly reduced following the operation. The preoperative motor evoked potentials were large and polyphasic, and consisted of early and late components. The late component was completely abolished after MST, suggesting that this component might be due to activation of the corticospinal tract neurones by long recurrent axon branches of dysplastic excitatory pyramidal neurones, which were cut by MST, or by delayed, polysynaptic intracortical conduction with marked temporal dispersion. Intracortical inhibition in the affected motor cortex was also disrupted preoperatively and improved after MST. Postoperative recruitment order of muscle responses to TMS was bilaterally symmetrical, indicating that MST did not interfere with the function of the corticospinal tract neurones. The patient showed fair motor recovery and good seizure control after the operation. These results of TMS studies demonstrated the remarkable effectiveness of MST not only on intractable seizure but also on abnormal motor cortical organization and hyperexcitability in cortical dysgenesis.