bluuebunny/crossref_metadata_2025 huggingface dataset:
Sublobar dysplasia—A clinicopathologic report after successful epilepsy surgery
Authors: Tuxhorn Ingrid , Woermann Friedrich G. , Pannek Heinz W. , Hans Volkmar H.
Published: October 2009

We report the clinical presentation, neuroradiologic characteristics, and detailed histopathologic findings in a unique case of drug‐resistant focal epilepsy due to sublobar dysplasia (SLD), treated successfully by resection of the malformed cortex. Histopathology with leptomeningeal and subcortical heterotopia, disturbance of cortical lamination and marked cortical and subcortical astrocytosis, but absence of balloon cells, points to a disorder of neuronal migration and organization rather than proliferation in SLD. The additional presence of a lateral proboscis and meningocele in our case as well as further associated callosal and cerebellar anomalies may suggest an etiologic unknown damage of pathways controlling the embryogenesis of craniofacial field processes.
Group‐specific regional white matter abnormality revealed in diffusion tensor imaging of medial temporal lobe epilepsy without hippocampal sclerosis
Authors: Shon Young‐Min , Kim Yeong‐In , Koo Bang‐Bon , Lee Jong‐Min , Kim Hye J. , Kim Woo J. , Ahn Kook J. , Yang Dong W.
Published: October 2009

Purpose:  In comparison to temporal lobe epilepsy (TLE) patients with hippocampal sclerosis (TLE‐HS), TLE patients without HS (TLE‐NH) have a similar clinical course but may result in worse surgical outcome. We investigated whether the clinical features related to the lack of HS in TLE patients (TLE‐NH) can be explained by water diffusion abnormalities throughout diffusion tensor imaging (DTI) by voxel‐based analysis.

Methods:  Nineteen patients with TLE‐HS (left/right TLE 12:7), 18 patients with TLE‐NH (left/right TLE 10:8), and 20 controls were included in the study. By statistical parametric mapping (SPM2), the diffusion properties specific to disease characteristics (TLE‐HS vs. TLE‐NH) were analyzed.

Results:  In TLE‐HS, we found the areas of increased mean diffusivity (MD) in their ipsilateral temporal and extratemporal areas including the hippocampus, parahippocampal, and frontoparietal regions. Left TLE‐HS showed a characteristic MD increase in the ipsilateral posterior cingulum, isthmus of corpus callosum, and contralateral occipital and temporal regions, which was not observed in right TLE‐HS group. In left TLE‐NH, two regions of increased MD were observed in the ipsilateral posterior fornix (within fusiform gyrus) and posterior cingulum. Right TLE‐NH did not show any increased MD.

Discussion:  In left TLE‐NH, we could find the water diffusion change along the posterior cingulum, which was quite different from the extensive abnormality from TLE‐HS. In addition, there was a lesion‐side–specific distribution (left predominant) of pathology in mesial TLE. This provides a possibility that TLE‐NH is a heterogenous or entity different from TLE‐HS.
Louis François Bravais and Jacksonian epilepsy
Authors: Eadie Mervyn
Published: October 2009

Although it is known that Jacksonian epilepsy was first described by Bravais in 1827, some 40 years before Jackson began his work on the topic, little has been published on what Bravais wrote. Louis François Bravais (1801–1843) came from a French provincial family, which made a number of scientific, mainly botanical, contributions. In his Paris M.D. thesis, based on 25 instances of what he termed “hemiplegic epilepsy,” Bravais described a set of unilateral epileptic seizure phenomena, including postseizure hemiparesis, very similar to those Jackson wrote about in 1870. However, Jackson accepted that the initially unilateral convulsive phenomena could spread to involve both sides of the body, whereas Bravais believed that this was incompatible with his entity, unless the generalization was a very rare event in the sufferer. Bravais in his account refused to go beyond descriptions of phenomena, whereas Jackson reasoned from the phenomena to a new concept of epileptogenesis, and also from them deduced that there must be localized representation of function in the cerebral cortex. Although Bravais had the priority, his work went largely unnoticed until Jackson’s insights had made their impact on medical thinking.
Bilateral hippocampal stimulation for intractable temporal lobe epilepsy: Impact on seizures and memory
Authors: McLachlan Richard S. , Pigott Susan , Tellez‐Zenteno Jose F. , Wiebe Samuel , Parrent Andrew
Published: October 2009

The effect of continuous electrical stimulation of the hippocampus bilaterally on seizures and memory was assessed in two subjects with seizures from both mesial temporal lobes who were not candidates for resective epilepsy surgery. A double blind, randomized, controlled, cross‐over trial design was utilized. Two electrodes with four contacts each were implanted along the axis of the hippocampus bilaterally. Simultaneous stimulation of all electrodes contacts was either on or off during each 3‐month interval. Seizure frequency decreased by 33% in the two patients during stimulation and remained lower by 25% for the 3 months after stimulation was turned off before returning to baseline (p < 0.01). No consistent change in objective or subjective measures of memory occurred. No other adverse effects occurred. Seizure frequency is reduced both during and for a period after bilateral hippocampal stimulation, but the overall impact in this study is not as robust as has been previously reported.
A comparison of midazolam nasal spray and diazepam rectal solution for the residential treatment of seizure exacerbations
Authors: De Haan Gerrit‐Jan , Van Der Geest Peter , Doelman Gerard , Bertram Edward , Edelbroek Peter
Published: October 2009

Rectal diazepam is established as a standard rescue or emergency treatment for seizure or status epilepticus; however, the rectal route of administration has not been universally accepted. To determine if an alternative route of administration of a benzodiazepine was equally effective, we compared a novel midazolam HCl concentrated nasal spray (MDZ‐n) with diazepam rectal solution (DZP‐r) in the treatment of prolonged seizures in a residential epilepsy center. In 21 adult patients with medically refractory epilepsy, 124 seizure‐exacerbations were treated by their caregivers, alternatively with 10 mg DZP‐r and 10 mg concentrated MDZ‐n, two or three treatments with each medication for each patient. No difference was demonstrated in efficacy or time to effect between the two drugs. Common treatment emerging adverse effects were drowsiness for both drugs in more than 50% of the administrations, and short‐lasting local irritation after 29% of MDZ‐n. No severe adverse events occurred. The nasal spray was preferred to the rectal solution by 16 of 21 caregivers and patients conjointly. MDZ‐n was equal to DZP‐r with respect to efficacy and side effects in the suppression of seizure exacerbations. The majority of patients and caregivers preferred the nasal spray over the rectal formulation.
The teratogenic risk of antiepileptic drug polytherapy
Authors: Vajda Frank J. E. , Hitchcock Alison A. , Graham Janet , O’Brien Terence J. , Lander Cecilie M. , Eadie Mervyn J.
Published: October 2009

Purpose:  To compare the risks of fetal malformation during pregnancy associated with antiepileptic drug (AED) polytherapy and monotherapy.

Methods:  Statistical analysis of malformation rate and antiepileptic drug exposure data from the Australian Register of Antiepileptic Drugs in Pregnancy, and from the literature.

Results:  The calculated relative risk (RR) value for AED polytherapy compared with monotherapy was below 1.0 in only 3 of 14 literature publications. In the register, at 1 year postnatally there were fetal malformations in 5.32% of 282 AED polytherapy pregnancies, and in 7.84% of 791 AED monotherapy pregnancies, an RR of 0.68 [95% confidence interval (CI) 0.39–1.17). For pregnancies exposed to valproate, the RR of fetal malformation (0.39, 95% CI 0.20–0.89) was lower in polytherapy (7.26%) than in monotherapy (17.9%); the difference did not depend on valproate dosage. The RR values for fetal malformation were not significantly different for AED polytherapy and monotherapy when valproate was not involved. Logistic regression suggested that coadministration of lamotrigine may have reduced the malformation risk from valproate.

Discussion:  The fetal hazard of AED polytherapy relative to monotherapy may depend more on the degree of exposure to valproate than on the fact of polytherapy per se. Coadministration with lamotrigine may lower the fetal risk of valproate therapy.
Preemptive effect of nucleus of the solitary tract stimulation on amygdaloid kindling in freely moving cats
Authors: Magdaleno‐Madrigal Victor M. , Martínez‐Vargas David , Valdés‐Cruz Alejandro , Almazán‐Alvarado Salvador , Fernández‐Mas Rodrigo
Published: October 2009

Purpose:  The nucleus of the solitary tract (NTS) is a primary site where vagal afferents terminate. The aim of this study was to analyze the preemptive effect of NTS electrical stimulation on daily amygdaloid kindling (AK) in freely moving cats.

Methods:  Seven adult male cats were used. Bipolar electrodes were stereotaxically implanted into both amygdalae, lateral geniculate bodies, hippocampi, and prefrontal cortices. In addition, a bipolar stainless steel electrode was implanted in the left NTS. Cats were recorded under the following experimental conditions: The NTS was stimulated for 6 days before the initiation of AK (1 min on/5 min off, 1 h total). AK was performed by stimulating the amygdala every 24 h (1 s, 60 Hz, 1 ms) until behavioral stage VI was reached.

Results:  The number of stimulations to reach stage VI in control animals was 23.4 ± 3.7, in lateral tegmental field (LTF) animals was 17.0 ± 2.1 days. Animals subjected to preemptive NTS stimulation showed a significant increase (53.8 ± 5.9). In addition, behavioral development was retarded, with an increase in the number of stimulations required to reach stage III. In this group, overall kindling development was delayed, and amygdaloid afterdischarge duration did not show a progressive increase as was observed in the control group.

Discussion:  Our results indicate that preemptive NTS electrical stimulation interferes with epileptogenesis. This anticonvulsive effect could be related to the activation of certain structures that inhibit seizure development. Therefore, results suggest that NTS mediates the anticonvulsive effect of vagus nerve stimulation.
Mammalian target of rapamycin (mTOR) inhibition as a potential antiepileptogenic therapy: From tuberous sclerosis to common acquired epilepsies
Authors: Wong Michael
Published: October 2009

Most current treatments for epilepsy are symptomatic therapies that suppress seizures but do not affect the underlying course or prognosis of epilepsy. The need for disease‐modifying or “antiepileptogenic” treatments for epilepsy is widely recognized, but no such preventive therapies have yet been established for clinical use. A rational strategy for preventing epilepsy is to target primary signaling pathways that initially trigger the numerous downstream mechanisms mediating epileptogenesis. The mammalian target of rapamycin (mTOR) pathway represents a logical candidate, because mTOR regulates multiple cellular functions that may contribute to epileptogenesis, including protein synthesis, cell growth and proliferation, and synaptic plasticity. The importance of the mTOR pathway in epileptogenesis is best illustrated by tuberous sclerosis complex (TSC), one of the most common genetic causes of epilepsy. In mouse models of TSC, mTOR inhibitors prevent the development of epilepsy and underlying brain abnormalities associated with epileptogenesis. Accumulating evidence suggests that mTOR also participates in epileptogenesis due to a variety of other causes, including focal cortical dysplasia and acquired brain injuries, such as in animal models following status epilepticus or traumatic brain injury. Therefore, mTOR inhibition may represent a potential antiepileptogenic therapy for diverse types of epilepsy, including both genetic and acquired epilepsies.
Interobserver and intraobserver reproducibility in focal cortical dysplasia (malformations of cortical development)
Authors: Chamberlain Wendy A. , Cohen Mark L. , Gyure Kymberly A. , Kleinschmidt‐DeMasters Bette K. , Perry Arie , Powell Suzanne Z. , Qian Jiang , Staugaitis Susan M. , Prayson Richard A.
Published: October 2009

Purpose:  Malformations of cortical development (MCD) (cortical dysplasias) are well‐recognized causes of intractable epilepsy. Although a histologic classification system for MCD has been proposed by Palmini et al. (Neurology; 2004; 62:S2), studies to date have not assessed reproducibility. The purpose of this study was to analyze inter‐ and intraobserver agreement among eight experienced neuropathologists (NPs) with respect to this classification system.

Methods:  Sections from 26 epilepsy resections were selected to represent the range of pathologies described by Palmini et al. Recuts of single sections from each case were sent to the NPs to classify. The slides were resent at a later date for reclassification. Kappa analysis for both inter‐ and intraobserver concordance was performed.

Results:  Interobserver agreement was moderate (κ = 0.4968). There was ≥62.5% (5 of 8 NPs) agreement for 19 of 26 cases. The greatest concordance was present when making focal cortical dysplasia (FCD) types IIA/B classifications (12 of the 14 cases with ≥75% consensus). Mild MCD (types I/II) and FCD types IA/B classifications were the least reproducible, and used most frequently in cases without consensus. Intraobserver concordance was moderate to very good (range κ = 0.4654–0.8504). The category with the fewest classification changes made on reevaluation was FCD type IIB (4.2%), whereas that with the most changes was mild MCD (types I/II) (52.9%).

Discussion:  Interobserver concordance using this approach was moderate. The classification categories with the greatest concordance were FCD type IIA/B, and the least, mild MCD and FCD types IA/B. In addition, difficulty in differentiating Mild MCD/FCD type I lesions from normal and/or gliotic tissue was noted.
Relevance of Endocavitary Structures in Ablation Procedures for Ventricular Tachycardia
Authors: ABOUEZZEDDINE OMAR , SULEIMAN MAHMOUD , BUESCHER TRACI , KAPA SURAJ , FRIEDMAN PAUL A. , JAHANGIR ARSHAD , MEARS JENNIFER A. , LADEWIG DOROTHY J. , MUNGER THOMAS M. , HAMMILL STEPHEN C. , PACKER DOUGLAS L. , ASIRVATHAM SAMUEL J.
Published: October 2009

Endocavitary Structures and Ventricular Tachycardia Ablation. Background: Radiofrequency (RF) ablation for ventricular tachycardia (VT) has high failure rates. Whether endocavitary structures (ECS) such as the papillary muscles (PMs), moderator bands (MBs), or false tendons (FTs) impact VT ablation is unknown.

Methods and Results:
We retrospectively reviewed records of 190 consecutive patients presenting for VT ablation and identified 46 (24%) where ECS affected ablation. In 31 of 46 patients (67%), the ECS created difficulty with catheter manipulation (n = 20), interpretation of pace map data (n = 7), or with accurately defining a scar (n = 4). In 15 of 46 (33%), specific mapping and RF energy delivery targeting the ECS itself was necessary to eliminate the arrhythmia.

Detailed electroanatomic mapping was performed in 11 of 15 (73%), noncontact mapping in 3 of 15 (20%), multielectrode catheter mapping in 1 of 15 (7%), and intracardiac ultrasound in 14 of 15 (93%) patients. The ablated ECS was a PM in 5 of 15, the MB in 7 of 15, and an FT in 3 of 15. The arrhythmogenic substrate on the ECS was a focus of automatic tachycardia in 9 of 15 and the slow zone responsible for reentrant arrhythmia in the remaining 6 of 15. Successful elimination of tachycardia without recurrence was obtained in all 15 cases. There was no evidence of valvular damage or disruption of the valvular apparatus.

Conclusion:
During VT ablation procedures, ECS should be considered for specific mapping and targeted ablation. Once recognized, these structures can be successfully targeted for ablation without valve damage. (J Cardiovasc Electrophysiol, Vol. 21, pp. 245–254, March 2010)
Developing a primary dental care outreach (PDCO) course – part 1: practical issues and evaluation of clinical activity
Authors: Hind V. , Waterhouse P. J. , Maguire A. , Tabari D. , Lloyd J.
Published: October 2009

Background:  The primary dental care outreach (PDCO) course in Newcastle, UK commenced in September 2004 with dental undergraduates attending outreach clinics on a fortnightly rotation over a 2 year continuous placement.

Objectives:  To evaluate the PDCO with respect to practical issues and clinical activity.

Methods:  Clinical activity data were collected using data sheets and Access software together with data on patient attendances and Structured Clinical Operative Tests (SCOTs). Comparative clinical data were collected from the same group of students in Child Dental Health (CDH) in the School of Dental Sciences.

Results:  In 2004/2005, 1683 clinical procedures were undertaken in PDCO and 1362 in CDH. Of the treatment undertaken in PDCO, 37.1% was examination and treatment planning, 17.1% basic intracoronal restorations and 13.1% fissure sealing, the activity representative of day to day in general practice. Completion rates for the five piloted SCOTs in cross infection control, writing a prescription, writing a referral letter, taking a valid consent and taking a radiograph ranged from 74% to 97% in 2004/2006. The practical issues and challenges of delivering a new clinical course broadly related to induction of new PDCO staff, support of staff, establishing effective communication, timetabling logistics, delivery of clinical teaching and quality assurance.

Conclusion:  Once the practical issues and challenges of setting up a new clinical course have been overcome PDCO has a valuable role to play in preparing undergraduates for their future practising careers.
Developing a primary dental care outreach (PDCO) course – part 2: perceptions of dental students
Authors: Maguire A. , Hind V. , Waterhouse P. J. , Tabari D. , Steen I. N. , Lloyd J.
Published: October 2009

Background:  The perspective of participating students in a primary dental care outreach (PDCO) course, with regard to clinical and educational value, has informed course development and delivery.

Objectives:  To evaluate students’ perception of the PDCO experience including clinical experience gained, teaching and learning and the teaching environment.

Methods:  Likert Scale‐based questionnaires were completed: (A) prior to the start of PDCO teaching, (B1) after one term, (B2) after one year and (C) for entry year 2001 students at completion. Additionally, a cohort of entry year 2000 students with no PDCO experience was surveyed at the end of their 4th year. Factor Analysis with Crohnbach’s alpha was used to investigate perception of (i) confidence and skills in treating child patients, (ii) confidence and skills in treating adult patients; (iii) general clinical skills and experience; (iv) team working. Data from entry years 2000–2003 were analysed using ANOVA and independent sample t‐tests.

Results:  For entry years 2001 and 2002, perceived confidence and skills in treating child patients and general clinical experience increased, although for entry year 2002 students the levels of perceived general confidence and skills achieved after 1 year were similar to the entry year 2000 cohort who had received no PDCO teaching. There was consistently high satisfaction with teamworking. After 2 years in PDCO, 11 of the 13 overall satisfaction scores were over 70%.

Conclusion:  The majority of students perceive PCDO as a valuable component of professional training and development. Further evaluation, including analysis of value for money, would help to inform funding decisions and further curriculum development.
Special care dentistry for people with intellectual disability in dental education: an Italian experience
Authors: Dellavia C. , Allievi C. , Ottolina P. , Sforza C.
Published: October 2009

Aim:  This study documented: (i) the curriculum in special care dentistry in the Italian dental schools, as perceived by Deans and by students, (ii) the rate of satisfaction of dental students with their curricular education in special care dentistry, (iii) the attitude of the dental students towards special care dentistry and towards the ‘Special Smiles’ programme.

Methods:  The quality and amount of didactic and clinical training delivered by each dental school for subjects with intellectual disability (ID), the interest of students towards this health field and the ‘Special Smiles’ programme were collected. Self‐administered surveys were sent to the Dean and to all the final year students of all dental schools in 20 Italian Universities.

Results:  Only four Deans of the 20 dental schools answered the survey, stating to provide didactic and clinical education in special care dentistry. A 51% of student response rate was obtained. Dental students reported to spend about 4% of didactic and 5% of clinical training in the dental care for ID subjects. Most students (83%) rated the training they had received on the topic to be poor. Over 50% of students expressed interest in working in dental offices specifically dedicated to ID patients and 25% of students wished to become Special Smiles volunteers.

Conclusions:  Although the paucity of didactic and clinical training in dental care for ID patients, this survey demonstrated a high level of student’s interest in learning more about treating these subjects. The current results could suggest to revise the curricular standards of dental schools, by promoting ID‐oriented education programmes.
Development of a rural outplacement programme for dental undergraduates: students’ perceptions
Authors: Abuzar M. A. , Burrow M. F. , Morgan M.
Published: October 2009

Objectives:  To describe the development and implementation of a new rural dental outplacement module in the final year curriculum and report initial student perceptions.

Methods:  The Melbourne Dental School, University of Melbourne, introduced a required 4‐week rural outplacement [termed Rural Dental Rotation (RDR)] in July 2006 to provide education and clinical training to all final year students. Seventy dental students (Bachelor of Dental Science and Bachelor of Oral Health) were rostered in groups of 6—10 students to Shepparton (Victoria, Australia), from July 2006 to June 2007 for 4 weeks per group. Students were introduced to the culture and oral health needs of the indigenous population in the region, and were involved in oral health promotion in specific health programmes. At the end of each roster students provided feedback of their experiences through a voluntary anonymous questionnaire.

Results:  The RDR offered a rural learning experience to all final year dental undergraduates and also provided dental services to the local community on a continuing basis. Students agreed that the RDR was a worthwhile experience (mean 4.77 ± 0.46 on 1—5 scale) and was ‘enjoyable’ (mean 4.71 ± 0.45). There was only one student who did not consider rural practice in future. This was because of family reasons. The majority (79.1%) expressed definite affirmation, whereas some (19.4%) indicated the possibility of taking up rural practice.

Conclusions:  Overall feedback indicated that the students found it a very positive and enjoyable experience. It provided an opportunity to appreciate cultural safety and understand the specific oral health needs of indigenous Australians. The key benefit of such a programme to the community is the increased likelihood of attracting new dental graduates to rural areas.
Undergraduates’ and graduates’ perception of achieved competencies in temporomandibular disorders and orofacial pain in a problem‐based dental curriculum in Sweden
Authors: Vallon D. , Nilner M.
Published: October 2009

Aims:  Aims of this study were to assess undergraduates’ and graduates’ perceptions of their education by documenting their attitudes and investigating acquired competencies in temporomandibular disorders (TMD) and orofacial pain (OP).

Methods:  In 2006, 141 undergraduates (in semesters 1, 6, and 10 of a 5‐year dental programme) and 60 graduates of 2000 and 2001 were invited to fill in questionnaires designed for their levels. The four questionnaires contained open‐ended questions, closed‐ended questions, and questions requiring a scaled response on an 11‐point numerical rating scale (NRS). Questions covered personal experience of pain, attitudes toward TMD/OP, clinical competencies, and satisfaction with their education. Participants rated importance of and satisfaction with clinical competencies on a 5‐point scale.

Results:  The importance of understanding TMD/OP patients was rated high (NRS 9—10) and attitudes to given statements about TMD/OP patients were positive. In general, perception of clinical competencies increased with level of education. Mean scores for importance of and satisfaction with clinical competencies of 10th semester undergraduates and graduates were above 4.0. Median graduate satisfaction with undergraduate education in TMD/OP patient management was high (NRS 9). All but one graduate had treated patients with TMD/OP. One‐third of the responding graduates expressed a wish for additional training, such as in pharmacological treatment and evaluation of treatment outcome.

Conclusion:  In general, the perception of acquired clinical competencies in TMD and OP increased with level of education, and the importance of, and satisfaction with, training was highly rated. Positive attitudes toward these kinds of patients were expressed at all levels.
Effect of directorial intervention on web‐based student feedback
Authors: Virtanen J. I. , Suomalainen K. , Aarnio M. , Silenti M. , Murtomaa H.
Published: October 2009

The Medical Faculty of the University of Helsinki decided to employ a web‐based evaluation system as an integral and essential part of all courses beginning in the autumn term of 2006.

Objectives:  To analyse the effects of the intervention on dental students’ web‐based responses at the University of Helsinki, Finland.

Subjects and Methods:  A previously developed web‐based tool was used for all preclinical and clinical courses from the beginning of the 2006—2007 academic year. We analysed data sets of student feedback for all courses before (2005—2006) and after (2006—2007) the intervention. We then compared the quantity and quality of the students’ feedback for the six standardised questions used in the evaluation, and calculated the means and standard deviations of values obtained with a Likert scale. The students’ assessments in the open questions were categorised according to key issues.

Results:  Implementation of the system resulted in a considerable increase in student feedback: the mean response rate for the preclinical phase rose from 59% (SD 15.0; range 25—80) before the intervention to 90% (SD 9.6; range 72—100) after it. In the clinical phase, the response rates more than doubled from 34% (SD 15.9; range 9—69) to 73% (SD 12.9; range 45—100). The students’ assessments showed no significant change despite the marked rise in response rates. The educators’ positive attitude towards the students was appreciated (4.2—4.3) whereas the general goals for the courses in the clinical phase seemed unclear to the students (3.4) (P < 0.05).

Conclusions:  Web‐based evaluation as an integral part of all courses in the dental curriculum proved successful: shortly after the intervention, we observed a considerable increase in student feedback with no significant change in quality.
Marathon of eponyms: 6 Frey syndrome (Gustatory sweating)
Authors: Scully C , Langdon J , Evans J
Published: October 2009

The use of eponyms has long been contentious, but many remain in common use, as discussed elsewhere (Editorial: Oral Diseases. 2009: 15; 185). The use of eponyms in diseases of the head and neck is found mainly in specialties dealing with medically compromised individuals (paediatric dentistry, special care dentistry, oral and maxillofacial medicine, oral and maxillofacial pathology, oral and maxillofacial radiology and oral and maxillofacial surgery) and particularly by hospital‐centred practitioners. This series has selected some of the more recognized relevant eponymous conditions and presents them alphabetically. The information is based largely on data available from MEDLINE and a number of internet websites as noted below: the authors would welcome any corrections. This document summarizes data about Frey’ syndrome.
Individual vulnerability to escalated aggressive behavior by a low dose of alcohol: decreased serotonin receptor mRNA in the prefrontal cortex of male mice
Authors: Chiavegatto S. , Quadros I. M. H. , Ambar G. , Miczek K. A.
Published: October 2009

Low to moderate doses of alcohol consumption induce heightened aggressive behavior in some, but not all individuals. Individual vulnerability for this nonadaptive behavior may be determined by an interaction of genetic and environmental factors with the sensitivity of alcohol's effects on brain and behavior. We used a previously established protocol for alcohol oral self‐administration and characterized alcohol‐heightened aggressive (AHA) mice as compared with alcohol non‐heightened (ANA) counterparts. A week later, we quantified mRNA steady state levels of several candidate genes in the serotonin [5‐hydroxytryptamine (5‐HT)] system in different brain areas. We report a regionally selective and significant reduction of all 5‐HT receptor subtype transcripts, except for 5‐HT3, in the prefrontal cortex of AHA mice. Comparable gene expression profile was previously observed in aggressive mice induced by social isolation or by an anabolic androgenic steroid. Additional change in the 5‐HT1Breceptor transcripts was seen in the amygdala and hypothalamus of AHA mice. In both these areas, 5‐HT1BmRNA was elevated when compared with ANA mice. In the hypothalamus, AHA mice also showed increased transcripts for 5‐HT2Areceptor. In the midbrain, 5‐HT synthetic enzyme, 5‐HT transporter and 5‐HT receptors mRNA levels were similar between groups. Our results emphasize a role for postsynaptic over presynaptic 5‐HT receptors in mice which showed escalated aggression after the consumption of a moderate dose of alcohol. This gene expression profile of 5‐HT neurotransmission components in the brain of mice may suggest a vulnerability trait for alcohol‐heightened aggression.
Isoform‐specific effects of apolipoprotein E on cognitive performance in targeted‐replacement mice overexpressing human APP
Authors: Kornecook T. J. , McKinney A. P. , Ferguson M. T. , Dodart J.‐C.
Published: October 2009

The ε4 allele of apolipoprotein E (apoE4) is the predominant genetic risk factor for late‐onset Alzheimer's disease (AD) and is also implicated in cognitive deficits associated with normal aging. The biological mechanisms by which APOE genotype affects cognitive processes or AD pathogenesis remain unclear, but interactions of apoE with amyloid β peptide (Aβ) are thought to play an important role in mediating apoE's isoform‐specific effects on brain function. Here, we investigated the potential isoform‐dependent effects of apoE on behavioral and cognitive performance in human apoE3 and apoE4 targeted‐replacement (TR) mice that also overexpress the human amyloid precursor protein (APP). Beginning at 6–7 months of age, female APP‐Yac/apoE3‐TR (‘poE3’) and APP‐Yac/apoE4‐TR (‘poE4’) mice were tested on a battery of tests to evaluate basic sensorimotor functioning, spatial working memory, spatial recognition, episodic‐like memory and attentional processing. Compared with apoE3 mice, a generalized reduction in locomotor activity was observed in apoE4 mice. Moderate, but significant, cognitive impairments were also detected in apoE4 mice in the novel object‐location preference task, the contextual fear conditioning test, and a two‐choice visual discrimination/detection test, however spontaneous alternation performance in the Y‐maze was spared. These results offer additional support for the negative impact of apoE4 on both memory and attention and further suggest that APP‐Yac/apoE‐TR mice provide a novel and useful model for investigating the role of apoE in mediating susceptibility to cognitive decline.
The capsid protein of human immunodeficiency virus: intersubunit interactions during virus assembly
Authors: Mateu Mauricio G.
Published: October 2009

The capsid protein (CA) of HIV‐1 is composed of two domains, the N‐terminal domain (NTD) and the C‐terminal domain (CTD). During the assembly of the immature HIV‐1 particle, both CA domains constitute a part of the Gag polyprotein, which forms a spherical capsid comprising up to 5000 radially arranged, extended subunits. Gag–Gag interactions in the immature capsid are mediated in large part by interactions between CA domains, which are involved in the formation of a lattice of connected Gag hexamers. After Gag proteolysis during virus maturation, the CA protein is released, and approximately 1000–1500 free CA subunits self‐assemble into a truncated cone‐shaped capsid. In the mature capsid, NTD–NTD and NTD–CTD interfaces are involved in the formation of CA hexamers, and CTD–CTD interfaces connect neighboring hexamers through homodimerization. The CA–CA interfaces involved in the assembly of the immature capsid and those forming the mature capsid are different, at least in part. CA appears to have evolved an extraordinary conformational plasticity, which allows the creation of multiple CA–CA interfaces and the occurrence of CA conformational switches. This minireview focuses on recent structure–function studies of the diverse CA–CA interactions and interfaces involved in HIV‐1 assembly. Those studies are leading to a better understanding of molecular recognition events during virus morphogenesis, and are also relevant for the development of anti‐HIV drugs that are able to interfere with capsid assembly or disassembly.
Cardiac conotruncal malformations in a family of beagle dogs
Authors: Diez‐Prieto I. , García‐Rodríguez B. , Ríos‐Granja A. , Cano‐Rábano M. , Peña‐Penabad M. , García C. Pérez
Published: October 2009

Objectives:To study forms of congenital heart disease present in a family of beagle dogs with a strong prevalence of ventricular septal defect and to document the pathological findings associated with the ventricular septal defects and investigate the mode of transmission.

Methods:The animals were investigated by physical examination, radiography, electrocardiography and ultrasonography to diagnose the presence of congenital heart disease. Some animals were diagnosed at post‐mortem examination and the dead animals underwent post‐mortem examination to verify the presence of ventricular septal defect. An analysis of pedigree was undertaken and two of the affected animals were mated to investigate the mode of transmission.

Results:Among the 28 dogs evaluated clinically or by post‐mortem examination, 14 cases of ventricular septal defect were identified. The post‐mortem examination showed some abnormalities of the ventricular outflow region associated with malformation of conotruncal septum development. When two affected dogs were bred, congenital heart disease was present in all of the offspring.

ClinicalSignificance:The congenital heart disease identified in this beagle family can be classified as conotruncal malformation, and an autosomal recessive mode of inheritance was suggested by pedigree analysis.
Lack of advantage of high‐fibre, moderate‐carbohydrate diets in dogs with stabilised diabetes§
Authors: Fleeman L. M. , Rand J. S. , Markwell P. J.
Published: October 2009

Objectives:To assess the influence of high‐fibre, moderate‐carbohydrate diets with two levels of dietary fat, compared with a commercial diet with moderate‐fibre, low‐carbohydrate and higher fat, on insulin requirement, glycaemic control and lipid profile of dogs with stabilised diabetes.

Methods:Twelve dogs with spontaneous diabetes mellitus were studied. Glycaemic control was evaluated by plasma fructosamine, glycosylated haemoglobin and 48‐hour serial blood glucose measurements. The insulin dosage required to maintain clinical stability was also determined. Lipid profiles comprised serial measurements of plasma cholesterol, triglyceride, free glycerol and free fatty acids. Data were analysed using analysis of variance.

Results:There were no significant differences in insulin requirement or glycaemic control among diets. Weight loss occurred when the dogs were fed the high‐fibre, moderate‐carbohydrate, moderate‐fat diet (P<0·002), whereas weight was maintained with the other two diets. The high‐fibre, moderate‐carbohydrate, moderate‐fat diet resulted in lower mean plasma cholesterol compared with either of the higher‐fat diets (P≤0·003), and lower mean plasma triglyceride (P=0·060), free fatty acid (P<0·001) and free glycerol (P=0·015) than the commercial diet.

ClinicalSignificance:For stable diabetic dogs, high‐fibre, moderate‐carbohydrate diets offered no significant advantage compared with a commercial diet with moderate fibre and low carbohydrate. Diets with high fibre, moderate carbohydrate and moderate fat should not be routinely recommended for dogs with thin body condition.
Idiopathic granulomatous and necrotising inflammatory disorders of the canine central nervous system: a review and future perspectives
Authors: Talarico Lauren R. , Schatzberg Scott J.
Published: October 2009

Granulomatous meningoencephalomyelitis, necrotizing meningoencephalitis, and necrotizing leukoencephalitis are common inflammatory conditions of the canine central nervous system. Although each disease has unique histopathological features, these canine disorders collectively seem to be aberrant immune responses directed against the central nervous system. A review of the neurological signs and general neurodiagnostic approach to canine meningoencephalitis is followed by an overview of the specific clinical and neuropathological features of granulomatous meningoencephalomyelitis, necrotizing meningoencephalitis, and necrotizing leukoencephalitis. The aetiopathogenesis of each disorder is explored including potential genetic, immunological, and environmental factors along with the current and prospective immunomodulatory therapies for meningoencephalitis.
Microtropis shenzhenensis sp. nov. (Celastraceae) from Guangdong, China
Authors: Chen Lin , Wang Fa‐Guo , Zhou Jin‐Song , Xing Fu‐Wu
Published: October 2009

Microtropis shenzhenensis L. Chen & F. W. Xing sp. nov. (Celastraceae), a new species from Shenzhen, China, is described and illustrated. It is compared with the morphologically similar species M. tetragona.
On the Numerical Prediction of Finite Length Squeeze Film Dampers Performance With Free Air Entrainment
Authors: Méndez Tilmer H. , Torres Jorge E. , Ciaccia Marco A. , Díaz Sergio E.
Published: October 2009

Squeeze film dampers (SFDs) are commonly used in turbomachinery to dampen shaft vibrations in rotor-bearing systems. The main factor deterring the success of analytical models for the prediction of SFD’s performance lies on the modeling of dynamic film rupture. Usually, the cavitation models developed for journal bearings are applied to SFDs. Yet, the characteristic motion of the SFD results in the entrapment of air into the oil film, producing a bubbly mixture that cannot be represented by these models. There is a need to identify and understand the parameters that affect air entrainment and subsequent formation of a bubbly air-oil mixture within the lubricant film. A previous model by and Diazand San Andrés (2001, “A Model for Squeeze Film Dampers Operating With Air Entrapment and Validation With Experiments,” ASME J. Tribol., 123, pp. 125–133) advanced estimation of the amount of film-entrapped air based on a nondimensional number that related both geometrical and operating parameters but limited to the short bearing approximation (i.e., neglecting circumferential flow). The present study extends their work to consider the effects of finite length-to-diameter ratios. This is achieved by means of a finite volume integration of the two-dimensional, Newtonian, compressible Reynolds equation combined with the effective mixture density and viscosity defined in the work of Diaz and San Andrés. A flow balance at the open end of the film is devised to estimate the amount of air entrapped within the film. The results show, in dimensionless plots, a map of the amount of entrained air as a function of the feed-squeeze flow number, defined by Diaz and San Andrés, and the length-to-diameter ratio of the damper. Entrained air is shown to decrease as the L/D ratio increases, going from the approximate solution of Diaz and San Andrés for infinitely short SFDs down to no air entrainment for an infinite length SFD. The results of this research are of immediate engineering applicability. Furthermore, they represent a firm step to advance the understanding of the effects of air entrapment on the performance of SFDs.
Advanced High Temperature Gas-Cooled Reactor Systems
Authors: Kato Yasuyoshi
Published: October 2009

Three systems have been proposed for advanced high-temperature gas-cooled reactors: a supercritical carbon dioxide (S-CO2) gas turbine power conversion system, a new microchannel heat exchanger (MCHE), and a once-through-then-out (OTTO) refueling scheme with burnable poison (BP) loading. A S-CO2 gas turbine cycle attains higher cycle efficiency than a He gas turbine cycle because of reduced compression work around the critical point of CO2. Considering temperature reduction at the turbine inlet by 30°C through intermediate heat exchange, the S-CO2 indirect cycle achieves an efficiency of 53.8% at a turbine inlet temperature of 820°C and a turbine inlet pressure of 20 MPa. This cycle efficiency value is higher by 4.5% than that (49.3%) of a He direct cycle at a turbine inlet temperature of 850°C and 7 MPa. A new MCHE has been proposed as an intermediate heat exchanger between the primary cooling He loop and the secondary S-CO2 gas turbine power conversion system and as recuperators of the S-CO2 gas turbine power conversion system. This MCHE has discontinuous “S-shaped” fins providing flow channels resembling sine curves. Its pressure drop is one-sixth that of a conventional MCHE with a zigzag flow channel configuration, but it has the same high heat transfer performance. The pressure drop reduction is ascribed to suppression of recirculation flows and eddies that appear around bend corners of the zigzag flow channels in the conventional MCHE. An optimal BP loading in an OTTO refueling scheme eliminates the shortcoming of its excessively high axial power peaking factor, reducing the power peaking factor from 4.44 to about 1.7, and inheriting advantages over the multipass scheme because it obviates reloading in addition to fuel handling and integrity checking systems. Because of the power peaking factor reduction, the maximum fuel temperatures are lower than the maximum permissible values of 1250°C for normal operation and 1600°C during a depressurization accident.
Laboratory Investigations of Low-Swirl Injectors Operating With Syngases
Authors: Littlejohn David , Cheng Robert K. , Noble D. R. , Lieuwen Tim
Published: October 2009

The low-swirl injector (LSI) is a lean premixed combustion technology that has the potential for adaptation to fuel-flexible gas turbines operating on a variety of fuels. The objective of this study is to gain a fundamental understanding of the effect of syngas on the LSI flame behavior, the emissions, and the flowfield characteristics for adaptation to the combustion turbines in integrated gasification combined cycle clean coal power plants. The experiments were conducted in two facilities. Open atmospheric laboratory flames generated by a full size (6.35 cm) LSI were used to investigate the lean blow-off limits, emissions, and the flowfield characteristics. Verification of syngas operation at elevated temperatures and pressures were performed with a reduced scale (2.54 cm) LSI in a small pressurized combustion channel. The results show that the basic LSI design is amenable to burning syngases with up to 60% H2. Syngases with high H2 concentration have lower lean blow-off limits. From particle image velocimetry measurements, the flowfield similarity behavior and the turbulent flame speeds of syngases flames are consistent with those observed in hydrocarbon and pure or diluted hydrogen flames. The NOx emissions from syngas flames show log-linear dependency on the adiabatic flame temperature and are comparable to those reported for the gaseous fuels reported previously. Successful firing of the reduced-scale LSI at 450 K<T<505 K and 8 atm verified the operability of this concept at gas turbine conditions.
Thermomechanical Fatigue Behavior of Bare and Coated CMSX-4
Authors: Coppola T. , Riscifuli S. , Tassa O. , Pasquero G.
Published: October 2009

Highly cooled turbine blades undergo very high thermal gradients during rapid engine idle-max-idle cycling. Traditional isothermal fatigue data are often insufficient for predicting service lives. A complete set of high temperature tests, in the range of 750–1050°C, was performed on single crystal alloy CMSX-4. The test program comprised tensile, creep, low cycle fatigue, and thermomechanical fatigue (TMF) tests. In particular the cycle time for TMF was 3 min, aiming to simulate the real high-power transient conditions in aircraft engines. Clockwise and counterclockwise diamond cycle types were applied on bare and coated specimens to investigate their influence on the fatigue limit. The comparison of the results obtained with the available ones from open literature is discussed.
The Plant Feature and Performance of Double MS (Modular Simplified and Medium Small Reactor)
Authors: Ikegawa Tomohiko , Kawabata Yukiko , Ishii Yoshihiko , Matsuura Masayoshi , Hirako Shizuka , Hoshi Takashi
Published: October 2009

A new concept of a small and medium sized light water reactor, named the double MS: modular simplified and medium small reactor (DMS) was developed. The main features of the DMS relative to overcoming the scale demerit are the miniaturization and simplification of systems and equipment, integrated modulation of construction, standardization of equipment layouts, and effective use of proven technology. The decrease in the primary containment vessel (PCV) height is achieved by reducing the active fuel length of the DMS core, which is about 2 m compared with 3.7 m in the conventional boiling water reactor (BWR). The short active fuel length reduces the drop in core pressure and overcomes the natural circulation system. By using the lower steam velocity in the upper plenum in the reactor pressure vessel (RPV), we can adopt a free surface separation (FSS) system. The FSS eliminates the need for a separator and thus helps minimize the RPV and PCV sizes. In order to confirm transient performance, the DMS plant performance under transient conditions was evaluated using the TRACG code. TRACG code, which can treat multidimensional hydrodynamic calculations in a RPV, is well suited for evaluating the DMS reactor transient performance because it can evaluate the void fraction in the chimney and therefore evaluate the natural circulation flow. As a result, the maximum change in the minimum critical power ratio of the DMS was 0.14, almost the same as for the current advanced boiling water reactor (ABWRs). In order to improve safety efficiency, developing an emergency core cooling system (ECCS) for the DMS was considered. The ECCS configuration in the DMS was examined to achieve core coverage and economic efficiency from the following: (1) eliminating high-pressure injection systems, (2) adopting passive safety-related systems, and (3) optimizing distribution for the systems and power source for the ECCS. In this way, the configuration of the ECCS for the DMS was established, providing the same level of safety as the ABWR and the passive systems. Based on the results of the loss of coolant accident analysis, we confirmed that the core can be covered by this configuration. Therefore, the plant concept was found to offer both economic efficiency and safety.