bluuebunny/crossref_metadata_2025 huggingface dataset:
Secretory antibodies against Giardia intestinalis in lactating Nicaraguan women
Authors: Téllez A. , Palm D. , Weiland M. , Alemán J. , Winiecka‐Krusnell J. , Linder E. , Svärd S.
Published: June 2005

Secretory IgA (sIgA) antibodies are important in the host defence against the intestinal protozoan parasite Giardia intestinalis. However, few antigens have been identified. In this study 100 milk and saliva samples from lactating women, living in an endemic region (León, Nicaragua), were screened for the presence of antibodies against G. intestinalis. Most milk and saliva samples contained anti‐Giardia antibodies (59% and 52%, respectively), with a mean sIgA content 50 times higher in milk than in saliva. The positive samples reacted with trophozoite membrane, flagella and cytoplasmic antigens. Western blot analysis showed that milk and saliva anti‐Giardia sIgA recognized up to 16 different Giardia proteins in the molecular weight region 20–165 kDa. Two‐dimensional Western blotting showed that the major immunoreactive proteins were the same as the immunoreactive proteins identified by serum from acute giardiasis patients in a non‐endemic country. The major difference was a stronger reactivity against the variant surface proteins (VSPs) in the milk samples. Milk sIgAs also recognized recombinant Giardia proteins such as alpha‐1 giardin, ornithine carbamoyl transferase, VSP‐4EX, arginine deaminase and alpha‐enolase. These antigens will be important targets in the development of new immunodiagnostic tools and vaccines.
Schistosoma infection inhibits cellular immune responses to core HCV peptides
Authors: Farid A. , Al‐Sherbiny M. , Osman A. , Mohamed N. , Saad A. , Shata M. T. , Lee D.‐H. , Prince A. M. , Strickland G. T.
Published: June 2005

Patients coinfected with hepatitis C virus (HCV) and the trematode, Schistosoma mansoni, have an increased incidence of viral persistence and accelerated fibrosis. To investigate immunological mechanisms responsible for this more aggressive natural history of HCV, the core HCV‐specific T‐cell responses were analysed in 44 donated blood units rejected because they had antibodies to HCV (anti‐HCV). Half also had anti‐S. mansoni antibodies, evidence of past or active infection. HCV‐specific ELISPOT responses were examined using pools of 180 overlapping 9‐mer peptides with offsets of one covering the core of HCV genotype 4a. Comparison of T‐cell responses in blood units positive for both anti‐HCV and anti‐Schistosoma antibodies with blood units positive only for anti‐HCV antibodies showed a significant decrease in core‐specific T‐cell IFN‐γ (505± 46 vs. 803 ± 66 ISC/106 cells, P < 0·001), IL‐4 (2 ± 108 vs. 641 ± 131 ISC/106 cells, P < 0·001), and IL‐10 (159 ± 105 vs. 466 ± 407 ISC/106 cells, P < 0·002) responses. In contrast, there was no significant difference in cell‐mediated immune response (CMI) to PHA mitogen between these two groups. Therefore, we concluded T cells from persons with anti‐Schistosoma have reduced IFN‐γ, IL‐4, and IL‐10 secreting HCV‐specific T‐cell responses. This may explain why Schistosoma coinfection increases persistence and severity of HCV infection.
An exploratory study of nurses suffering from severe acute respiratory syndrome (SARS)
Authors: Mok Esther , Chung Betty PM , Chung Joanne WY , Wong Thomas KS
Published: June 2005

In 2003, severe acute respiratory syndrome (SARS) came to be recognized as a newly emergent form of disease that is highly contagious. The aim of this study was to describe the perceptions of nurses with SARS in Hong Kong, as the perceptions of nurses who have suffered from SARS have not been studied. Ten nurses who had suffered from SARS were interviewed, either face‐to‐face or by telephone, about their subjective experiences. These interviews provided in‐depth, descriptive data, which were analysed using content analysis. Nine broad categories were identified: uncertainty, information control, feelings of anger and guilt, lack of preparation and fear of death, feelings of isolation and loneliness, physical effects, support, change of perspective of life, and change of perspective of nursing. Although the dreaded disease affected the nurses tremendously, both physically and psychologically, it has also had its positive side. As a result of experiencing the illness, the participants came to treasure relationships, health and everyday life more. In caring for patients, they came to see the world more from the perspective of the patients. They found that they need to take the time to reassure patients and families and to seriously listen to all of their concerns.
Very young children are insensitive to picture‐ but not object‐orientation
Authors: Pierroutsakos Sophia L. , DeLoache Judy S. , Gound Mary , Bernard E. Nicole
Published: June 2005

In two experiments on very young children's response to the orientation of pictures and objects, 18‐, 24‐ and 30‐month‐old children showed no preference for upright pictures over inverted ones. More importantly, we found that children in all three age groups were equally accurate and equally fast at identifying depicted objects regardless of orientation. These studies further established that young children's insensitivity to picture orientation does not extend to objects. These results, in combination with the earlier ones, indicate that only gradually do young children come to share the picture orientation preference of adults and older children and that their adoption of the orientation convention is not based on changes in their ability to process upright and inverted images.
Is “Private Briefing” Illegal in the United Kingdom?
Authors: Al‐Hawamdeh Ahmed , Snaith Ian
Published: June 2005

In recent years there has been some debate and uncertainty about the legality of private briefings of some market participants with the management of listed companies in the UK. The Myners (2001) and Higgs (2003) Reports have suggested an increasingly active role for institutional shareholders. However, the message from the Financial Services Authority in its role as the United Kingdom Listing Authority has been that private briefings may be unlawful. This article explores the meaning and scope of the legal rules on insider dealing and market abuse under the Financial Services and Markets Act 2000, the Criminal Justice Act 1993 and those parts of the Listing Rules that govern such briefings. The extent to which such rules apply to various types of meeting between corporate managers and other market participants, such as institutional investors, and the information provided in those meetings, will also be examined. The paper concludes that the mismatch between the apparent legal position and the policy objective of the Government of increasing institutional shareholders’ activism requires a resolution.
A7445G mtDNA mutation present in a Portuguese family exhibiting hereditary deafness and palmoplantar keratoderma
Authors: Caria H , Matos T , Oliveira‐Soares R , Santos AR , Galhardo I , Soares‐Almeida L , Dias O , Andrea M , Correia C , Fialho G
Published: June 2005

Mitochondrial DNA (mtDNA) A7445G point mutation has been shown to be responsible for familial nonepidermolytic palmoplantar keratoderma (NEPPK) associated with deafness without any additional features. To date, only a few cases have been described. We report a Portuguese pedigree presenting an inherited combination of NEPPK and sensorineural deafness compatible with maternal transmission. Clinical expression and age of onset of NEPPK and deafness were variable. Normal expression patterns of epidermal keratins and filaggrin, intercellular junction proteins including connexin 26, loricrin and cornified envelope proteins, were observed. Molecular analysis revealed that all the affected members, previously screened for Cx26 mutations with negative results, presented the mtDNA A7445G point mutation in the homoplasmic form. To our knowledge, this is the fifth family in whom inherited NEPPK and hearing loss are related to this mitochondrial mutation.
Multiple myeloma with scleroderma‐like changes
Authors: Paredes‐Suárez C , Fernández‐Redondo V , Blanco M Vázquez , Sánchez‐Aguilar D , Toribio J
Published: June 2005

We present a case of a patient who presented concomitantly with generalized pruritus, brownish sclerodermatous plaques, sclerodactyly and a monoclonal band for IgG‐kappa. The patient was diagnosed as having multiple myeloma by bone marrow examination. The rapidly progressive evolution with acute anuric renal failure, malignant hypertension and the skin sclerosis seem to be related to the neoplastic disorder. The scleroderma‐like changes have to be differentiated from systemic scleroderma.
Erythema dyschromicum perstans in children: a report of 14 cases
Authors: Torrelo Antonio , Zaballos Pedro , Colmenero Isabel , Mediero Imelda G. , De Prada Inmaculada , Zambrano Antonio
Published: June 2005

Background  Erythema dyschromicum perstans (EDP) or ashy dermatosis is a peculiar, slowly progressive, macular hyperpigmentation, which leaves a permanent discoloration. It is an acquired dermatosis that occurs most frequently in Central and South America. EDP usually appears in adults, but some isolated cases and small series have been reported in prepubertal children.

Methods  A retrospective review of cases of EDP in 10‐year‐old children or younger, attended in a pediatric hospital between 1990 and 2003.

Results  We present 14 cases of EDC in children 10 years and younger. With an additional 25 cases reported so far in the English language literature, a total of 39 children have been described. Unlike adult patients, who are most commonly of Hispanic origin, children with EDP are usually Caucasian. Other important facts in children with EDP are the absence of consistent trigger factors and an eventual improvement or resolution of the lesions in 50% of prepubertal patients.

Conclusion  We suggest that EDP is a distinctive clinical entity, different from lichen planus and lichen planus pigmentosus, which may be identical to the so‐called idiopathic eruptive macular pigmentation.
Screening of Chlamydia trachomatis urogenital infections among the male and female population of the Republic of Macedonia
Authors: Spasovski Miroslav S. , Simjanovska Liljana J. , Taleski Vaso , Petrova Nada , Lazetic Liljana , Popeska Zaneta , Gaydos Charlotte A. , Quinn Thomas C. , Efremov Georgi D.
Published: June 2005

Background  Noninvasive urine screening for Chlamydia trachomatis infections offers a valuable public health tool, that could be of vast importance in Chlamydia control programs.

Objective  The goal was to determine the prevalence of C. trachomatis infections among a sexually active population, to define the epidemiological factors associated with it, and to develop potential selective screening strategies among asymptomatic individuals in the Republic of Macedonia, using a highly sensitive and specific DNA amplification method for C. trachomatis.

Study design  A total of 1435 urine samples, divided into two main groups: asymptomatic individuals (n = 1210) and symptomatic patients (n = 225), were tested. Samples from the asymptomatic group were collected during routine screening programs, while the symptomatic group consisted of patients with symptoms of urogenital tract infection, attending sexually transmitted diseases (STD) clinics. The presence of C. trachomatis was determined using commercial AMPLICOR C. trachomatis Assay (Roche Diagnostic Systems, Inc., Branchburg, NJ, USA).

Results  The prevalence of C. trachomatis infections among different groups was: recruits 0%, soldiers 0.4%, policemen 3.5%, clerks 4.6%, pregnant women 4%, and students 4.4%. The average prevalence for both groups (asymptomatic and symptomatic) was 2.3%[95% confidence interval (CI): 1.5–3.1%]. The average prevalence for the asymptomatic group was 1.6% (95% CI: 0.8–2.4%), while the average prevalence for the symptomatic group was 6.2% (95% CI: 3.1–9.3%) which were significantly different (P = 0.00003).

Conclusion  Testing first void urine specimens by AMPLICOR C. trachomatis assay is a highly sensitive and specific method for diagnosing C. trachomatis infections in men and women. This method provides health care workers and public health officials with a new molecular amplification assay that uses noninvasive urine specimens for population‐based screening purposes. The prevalence of C. trachomatis was relatively low among asymptomatic individuals. However, selective screening strategies are highly recommended for testing the student population in the Republic of Macedonia.
Epidermal stem cells
Authors: Barthel R , Aberdam D
Published: June 2005

The identification of adult epidermal stem cells that are capable of self‐renewal and can reconstitute not only the epidermis but also the cutaneous appendages opens new perspectives for the treatment of a variety of human skin disorders including severe burns, cutaneous cancers, alopecia and acne. However, the implementation and improvement of these novel treatment strategies require a better understanding of the biology of stem cells, in particular regarding their isolation and the maintenance of their unique characteristics in culture. In this review, we summarize the main features of epidermal stem cells and we present the most recent advances in our understanding of the development and maintenance of these cells. In addition, we discuss some of the challenges and the potential clinical applications of epidermal stem cell technology.
Stroke and Orgasmic Cephalgia
Authors: Levy Richard L.
Published: June 2005

SYNOPSIS

A 24‐year‐old man suffered a stroke in association with orgasmic cephalgia, without evidence of intracranial hemorrhagic disease. It is postulated that this is an example of complicated migraine coincident with sexual climax and that benign orgasmic cephalgia is a migraine variant.
Personality Profiles in Cluster Headache and Migraine
Authors: Cuypers J. , Altenkirch H. , Bunge S.
Published: June 2005

SYNOPSIS

40 cluster headache patients and 49 migraine patients described their personality using the Freiburg Personality Inventory (FPI). Cluster headache patients had a slightly elevated score in scale 1 (nervousness) and a slightly diminished score on scale M (masculinity). On scale 1 migraine patients displayed a score at the upper borderline of the average range. Both groups evidenced normal values in all the other scales. Our results do not favour the view that neurotic mechanisms play a decisive role in these patients.
Lithium Carbonate Has No Measurable Effect on Cerebral Hemodynamics in Cluster Headaches
Authors: Okayasu Hiroyuki , Meyer John Stirling , Mathew Ninan T. , Amano Takahiro , Hardenberg Jeffrey
Published: June 2005

SYNOPSIS

Any effects of lithium carbonate (oral dosage 900 mg/day) on measurements of cerebral hemodynamics were examined in 10 carefully selected patients meeting criteria of chronic cluster headache, i.e., headache‐free intervals were less than 3 weeks in duration per year. Cerebral blood flow (CBF) was measured by the 133Xe inhalation method before and 2‐4 weeks after (mean 3 weeks) standard recommended lithium carbonate administration, as a dose of 300 mgs give orally three times per day (total 900 mg/24 hours).Cerebral vasoconstrictor responsiveness was tested by repeated CBF measurements during serial inhalations of 100% O2 followed by 5% CO2 in air mixtures. Mean values for hemispheric gray matter flow were 70.9 ml/100g brain/min measured over the side of the cluster headaches and 70.0 ml over the contralateral side prior to lithium and 68.0 ml for sides of the head after lithium treatment. These differences before and after treatment were not significant. Cerebral vasodilator responsiveness to 5% CO2 was expressed as per cent gray matter flow change per mmHg change of measured PECO2 . Compared to values measured in normal age‐matched controls, CO2 responsiveness was diminished bilaterally, both prior to and during lithium administration and there were no significant changes induced after treatment with the drug. Likewise cerebral vasoconstrictor responses during 100% oxygen inhalation were not altered by lithium treatment.
Migraine, Seizures and Epileptic Focal E.E.G. Abnormalities in a Young Adult: a Nine‐year Follow‐up
Authors: Gil R. , Lefevre J.P. , Burelout Y.
Published: June 2005

SYNOPSIS

We have studied a 24‐year‐old woman followed over a nine year period for episodes of migrainous aura sometimes preceding convulsive seizures and associated with persistent and fluctuant focal and paroxysmal E.E.G. abnormalities: the latter appeared on most recordings and involved the left occipital region. All others investigations remained normal and the clinical course was benign. This case resembles the four cases reported by Camfield et al and an additional case reported by Panayiotopoulos. However our case shows that this syndrome may occur in adults (all the previously reported cases concerned adolescents); moreover our observation shows that convulsive seizures may be or not preceded by migrainous aura, that E.E.G. abnormalities may fluctuate when observed during a long term period (nine years); finally, such as in one case reported by Camfield et al the E.E.G. abnormalities were focal.
Migraine and Cluster Headache: Links Between Platelet Monoamine Oxidase Activity, Smoking and Personality
Authors: Littlewood Julia T. , Glover Vivette , Sandler M. , Petty R. , Peatfield R. , Rose F. Clifford
Published: June 2005

SYNOPSIS

The incidence of smoking in a group of male cluster headache patients (95%) was significantly (P<0.001) greater than in a matched group of male migrainous patients (26%). Both groups had significantly lower platelet monoamine oxidase activity than controls. This finding may be connected genetically with certain personality characteristics, including predisposition to smoke. It is possible that migrainous patients smoke less than those with cluster headache because the process of smoking has a greater tendency to provoke their headache attacks.
Development of a Computer‐assisted Headache Diagnostic and Treatment System
Authors: Francis James H. , Pennal Billy E. , Wadsworth Wynelle
Published: June 2005

SYNOPSIS

The use of a computer for the diagnosis and treatment of headache has been limited; however, studies have suggested its feasibility. In the severe chronic headache sufferer there is difficulty in obtaining and assimilating the diagnostic data. This report describes the first phase of a three‐phase project in implementation of a computer as an aid in actual diagnosis and treatment planning for the chronic headache patient. Input into the computer is accomplished with a patient and a physician questionnaire. The computer sorts, analyzes and compares the data with known diagnostic and treatment criteria and weights the relationships numerically. The results are printed in reports including diagnostic impression and differential diagnosis based on the total value accumulated toward those diagnoses. In addition, information is printed to provide physician and patient information specific to the headache diagnoses. A recommended treatment protocol is given for each headache type. For differential diagnoses, specific confirming tests are recommended. References are provided on the report for the diagnoses found and treatment protocols recommended.
Further Evidence on the Association of Mitral Valve Prolapse and Migraine
Authors: Gamberini G. , D'Alessandro R. , Labriola E. , Poggi V. , Manzoni G.C. , Carpeggiana P. , Sacquegna T.
Published: June 2005

SYNOPSIS

Two populations of patients, one with common migraine and the other with mitral valve prolapse (MVP), were analyzed to define the relationship between these conditions. Of 100 consecutive patients with migraine, 20 had MVP; of 100 consecutive patients with MVP, 51 suffered from migraine headache. As for features of migraine are concerned, the patients with MVP‐migraine association did not significantly differ from the patients with migraine alone. On the basis of reports in the literature, it remains to be seen whether this association involves a greater risk of cerebrovascular events.
Subcutaneous Sumatriptan in Cluster Headache: A Time Study of the Effect on Pain and Autonomic Symptoms
Authors: Hardebo Jan Erik
Published: June 2005

SYNOPSIS

A subcutaneous injection of 6 mg sumatriptan rapidly and effectively stopped attacks of cluster headache. After a time lag of 4–14 minutes (mean 7 minutes) pain dramatically dropped to zero within seconds to single minutes (mean 56 seconds). This rapid effect may indicate that mere vasoconstriction is the mechanism behind the beneficial effect of sumatriptan in cluster pain. The findings support a scenario in cluster headache where an inflammation in the cavernous sinus affects the sympathetic fibers traversing the cavernous region. This leads to the miosis, ptosis and forehead anhidrosis but also to a dilated internal carotid arterial tree distal to the lesion. The dilatation, in combination with an obliterated drainage of the cavernous sinus by the inflammatory process, leads to progressive stasis in the sinus, to cause the painful attack. The attack terminates when the enhanced load on the sinus is reduced by constriction of vessels supplying the sinus, as is achieved by administration of sumatriptan. The present observation that other accompanying symptoms during attacks (nasal congestion, rhinorrhea, lacrimation and swelling of eyelids) disappeared in parallel with the pain points to the possibility that these symptoms may be directly related to venous stasis or activation of pain fibers, rather than resulting from a primary parasympathetic activation.
Suggestibility and Headache Reports in Schoolchildren: A Problem in Epidemiology
Authors: Passchier J. , Hunfeld J.A.M. , Jelicic M , Verhage F.
Published: June 2005

SYNOPSIS

In a sample from the general population of school children of 15 years of age, we studied whether receiving information about the prevalence of headaches had any effect on their subsequent headache report. Sixty children in the fourth year at four secondary schools were allocated at random to two conditions: a biased condition emphasizing the high prevalence of headaches and a neutral condition. Subjects in the biased condition reported more headaches but they did not report more other physical symptoms than the subjects in the neutral condition. The results are discussed in terms of Pennebaker's theory on reporting symptoms. It is concluded that epidemiological research using the general population should deal more explicitly with the way in which subjects are motivated to participate.
Computed Tomography in the Headache Patient: Is Routine Evaluation Really Necessary?
Authors: Mitchell Craig S. , Osborn Robin E. , Grosskreutz Scott R.
Published: June 2005

SYNOPSIS

Objective. To determine the likelihood ratio of a positive computed tomogram of the brain in the routine evaluation of headache patients.

Design. Consecutive patients with a chief complaint of headache were prospectively evaluated with computed tomography of the brain. Patients with headaches complicating other clinical disorders such as trauma, postictal state or known intracranial neoplasm were excluded.

Setting. Military tertiary care center.

Patients. Consecutive sample of 350 patients with a chief complaint of headache, regardless of the presence or absence of physical or neurologic signs, were referred for computed tomography of the brain. The patients were referred from a variety of inpatient and outpatient settings.

Results. Seven (2%) of the 350 patients had computed tomographic findings that were clinically significant. An additional 25 (7%) had positive computed tomographic findings, which were clinically insignificant for findings. All of the patients with significant computed tomographic findings had an abnormal physical or neurologic exam or unusual clinical symptoms.

Conclusion. Routine computed tomography of the brain in headache patients with normal physical and neurologic exams and no unusual clinical symptoms has a low likelihood ratio for discovering significant intracranial disease.
Subcutaneous Sumatriptan in the Treatment of Acute Episodes of Posttraumatic Headache
Authors: Gawel Marek J. , Rothbart Peter , Jacobs Howard
Published: June 2005

SYNOPSIS

Seven patients with posttraumatic headaches refractory to other medical treatment were treated with sumatriptan, 6 mg subcutaneously, at the peak of a headache. In all, the throbbing temporal part of the headache disappeared leaving a persistent occipital pain. It is postulated that involvement of the trigeminovascular system is involved in part of the pain of posttraumatic headache, making it amenable to treatment with sumatriptan.
Psychological Status During Migraine Attack and Interval Before and After Treatment With a Selective 5‐HT1‐Agonist
Authors: Göbel Hartmut , Krapat Susanne
Published: June 2005

SYNOPSIS

The study recorded the quantitative changes in psychological status during migraine attack and interval in 20 migraine patients. It further determined their psychological status after administration of the selective 5‐HT1‐agonist sumatriptan and placebo during migraine interval and migraine attack. Psychological status was classified with the aid of an adjective list enabling quantitative description of 15 essential aspects of the subjects' current disposition. The results demonstrate a drastic deterioration in psychological status during an acute migraine attack as compared to the migraine interval and plainly show how badly migraine affects the patients, as almost all the aspects of psychological status are impaired.

Administration of placebo did not significantly Influence current disposition either in the migraine interval or during the attack. Sumatriptan minimally increased Inactivity and dizziness during the migraine interval. During an attack sumatriptan completely normalized current disposition within 30 minutes by significantly improving the impaired dimensions. It is conceivable that this rapid normalization is due to the reduction in pain severity and is only a secondary effect of the rapid alleviation of pain. It is also possible that a direct effect of the selective 5‐HT1‐agonist on the central nervous system may be the cause of this rapid normalization of current disposition.
Exteroceptive Silent Periods of Temporalis Muscle Activity: Correlation with Neuropsychological Findings
Authors: Wallasch Thomas‐Martin , Niemann Ulrike , Kropp Peter , Weinschütz Thomas
Published: June 2005

SYNOPSIS

The latency and duration of the early (ES 1) and late (ES 2) exteroceptive silent period of temporalis muscle activity were determined in 51 neurological patients. We investigated whether these electrophysiologicalparameters correlated with neuropsychological variables of the patients using standardized scores for personality index, state of well‐being and physical symptoms. There were no correlations between personality traits and the electrophysiological parameters, while we found significant correlations between the duration of ES 2 and momentary psychological and physical well‐being variables. Moreover, the score of the momentary well‐being item ‘general feeling of well‐being’ was demonstrated to moderate significantly the ES 2 duration (P = 0.018). Therefore, neuropsychological factors prove to be of great relevance to the exteroceptive silent periods of temporalis muscle activity.
Deficiency In Serum Ionized Magnesium But Not Total Magnesium In Patients With Migraines. Possible Role Of Ica2+/IMg2+ Ratio
Authors: Mauskop A. , Altura B.T. , Cracco R.Q. , Altura B.M.
Published: June 2005

SYNOPSIS

It has been suggested that magnesium (Mg) may play a role in the pathogenesis of headaches. Serum and intracellular measurements of Mg in headache patients have produced inconsistent results. The recent development of an ion‐selective electrode for Mg2+ allowed precise measurement of serum ionized magnesium (IMg2+) in patients with various headache syndromes. Low serum Img2+ and a high ICa2+/IMg2+ ratio were found in 42% of patients having an attack of migraine, but only in 23% of patients with e severe continuous headache. Total serum Mg was normal in both groups of patients. However, in patients with low serum IMg2+ total serum Mg was lower than in patients with normal serum IMg2+. These results are compatible with the serotonin and vascular concepts of migraine pathogenesis. Low IMg2+ and a high ICa2+/Img2+ would result in cerebral vasospasm and reduced blood flow in the brain. The activity of serotonin receptors can also be affected by changes in IMg2+ levels. The finding of a difference in IMg2+ levels in two different headache types suggests a possible novel classification of headaches and that migraine patients with a low serum IMg2+ or a high ICa2+/IMg2+ ratio may benefit from Mg supplementation.
Psychophysiological and MMPI Personality Assessment of Headaches: An Integrative Approach
Authors: Williams D.E. , Raczynski J.M. , Domino Julia , Davig J.P.
Published: June 2005

SYNOPSIS

Multiple psychophysiological measures and personality assessment techniques were combined to facilitate the diagnosis of headache type and improve upon existing methodology. Twenty‐four migraine, 24 chronic tension headache patients, and 24 normal age‐ and gender‐matched controls were assessed with bilateral measures of frontalis and occipitalis EMG and blood volume pulse. All subjects completed the MMPI. Results suggest that headache subjects could be differentiated on baseline heart rates and MMPI scales 1,2,3, and 7. Only one physiological measure served as an index of psychological distress, suggesting issues of an interaction between psychophysiological and personality variables, as well as the chronicity of the headache.
Disposition of Naproxen After Oral Administration During and Between Migraine Attacks
Authors: Pini L.A. , Bertolotti M. , Trenti T. , Vitale G.
Published: June 2005

SYNOPSIS

Naproxen is an anti‐inflammatory drug widely used in the management of pain and in the treatment of migraine and headache. As gastrointestinal disturbances are a common feature of migraine, the aim of this study was to evaluate the absorption and the efficacy of naproxen administered during migraine attacks. Ten patients were treated with 500 mg of a soluble form of naproxen during and between migraine attacks. Clinical parameters and drug plasma levels were recorded st scheduled times. Pain reduction, from severe to mild was evident by 6.5 ± 3.4 hours and the total pain score showed a reduction from 2 hours onwards. Pharmacokinetic data showed a slight delay in drug absorption during attacks (absorption half‐life and time of maximum drug concentration were increased during attacks), but overall bioavailability of naproxen, as reflected by area under the curve (AUC) and maximum plasma drug concentration were unchanged. Since pain relief was reported, it may be concluded that delayed absorption has little or no influence on the therapeutic effect of naproxen in migraine attacks in fasting patients.
Non‐Compliance With Follow‐Up and Improvement After Treatment at a Headache Center
Authors: Spierings Egilius L.H. , Miree Lucia F.
Published: June 2005

SYNOPSIS

Two telephone surveys were conducted at a major headache center into patient compliance with follow‐up end perceived treatment efficacy. The first survey addressed compliance with the recommendation to follow‐up after the initial evaluation. Of a group of 316 consecutive patients, 40.5% had not complied with the recommended follow‐up visit. Reasons for the non‐compliance were given by 60.3%; most frequently mentioned were dislike of the clinician seen and seeking care elsewhere.

The second survey concerned 75 patients who had returned at least once to the center for follow‐up. When asked about the efficacy of the treatment received, 76.0% reported improvement of their headaches, with 32.0% reporting more than 75% improvement. In addition, 87.5% of the patients reported a decrease in the use of analgesic and/or ergotamine medications.

We conclude that treatment of chronic headache is not a priori a hopeless situation and that in the patient compliance with the recommendation to follow‐up, in particular the patient‐clinician relationship is a critical factor.
The Comparison of Patients Suffering from Temporo‐mandibular Disorders and a General Headache Population
Authors: Haley Dennis , Schiffman Eric , Baker Camak , Belgrade Miles
Published: June 2005

SYNOPSIS

The purpose of this study was to examine the possible association of signs and symptoms of temporomandibular disorders relative to headache. Fifty‐six sequential patients referred to the Headache Institute of Minnesota for evaluation and treatment of migraine and tension headaches were examined for signs and symptoms of temporomandibular disorders. The results of the examination of headache patients were compared to patients suffering from myofascial pain dysfunction and/or TMJ internal derangements from the TMJ and Craniofacial Pain Clinic at the University of Minnesota. Finally the migraine and tension headache patients were compared to each other and an asymptomatic population.

Results indicate that patients with temporomandibular disorders exhibit significantly more jaw dysfunction and pericranial muscle tenderness than migraine and tension headache patients. Migraine and tension headache patients were found to have similar amounts of pericranial muscle tenderness. Migraine and tension headache patients exhibited significantly more pericranial and neck muscle tenderness than a general population.
Differential GABAA Subunit Expression Following Status Epilepticus in Seizure‐prone and Seizure‐resistant Rats: A Putative Mechanism for Refractory Drug Response
Authors: Gilby Krista L. , Da Silva Angelika Goncalves , McIntyre Dan C.
Published: June 2005

Summary:  Purpose: Two rat strains were selectively bred to be prone (Fast) or resistant (Slow) to amygdala kindling. The first objective of this experiment was to determine whether that selection was specific to kindling or was sensitive more broadly to another seizure induction agent, kainic acid (KA). Second, we investigated whether these strains exhibit distinct molecular responses to KA with respect to GABAA receptor subunit expression.

Methods: Development of status epilepticus (SE) was profiled in Fast and Slow rats injected with 20 mg/kg KA (i.p.). Two hours post‐SE onset, rats received a sedative dose of sodium pentobarbital. Behavioral profiles included latency to SE, number of wet dog shakes (WDS), and number and duration of stage 3–5 generalized seizures. Rats were killed 24 h post‐SE, and α1 and α4 mRNA levels were compared in the hippocampus and amygdala using QPCR.

Results: Slow rats exhibited a much greater latency to SE onset (p < 0.01) and many more WDS (p < 0.01) than Fast rats. During SE, Fast rats spent more time in and exhibited more repeated bouts of generalized stage 3–5 seizures (p < 0.01) than Slow rats. Constitutive levels of α1 and α4 were not different between the strains in either structure and equivalent reductions in α4 were evident 24 h post‐SE. However, while Fast rats showed KA‐induced reductions in α1 in both structures, Slow rats showed significant elevations.

Conclusions: Genetic selection for temporal lobe excitability, manifested as differential amygdala kindling rates, is paralleled by vulnerability to KA‐induced SE. Further, these strains exhibited at least one opposing molecular response to SE, namely α1 expression. This finding may offer a putative mechanism through which seemingly similar epilepsies can be intractable in some patients but treatable in others.
Are Cytomegalic Neurons and Balloon Cells Generators of Epileptic Activity in Pediatric Cortical Dysplasia?
Authors: Cepeda Carlos , André Véronique M. , Vinters Harry V. , Levine Michael S. , Mathern Gary W.
Published: June 2005

Summary:  Purpose: Severe cortical dysplasia (CD) is characterized by the presence of cytomegalic neurons and balloon cells. These aberrant cells could participate in the generation of epileptic activity. The aim of this study was to morphologically and electrophysiologically characterize cells in pediatric CD tissue.

Methods: We used infrared video‐microscopy to visualize normal and abnormal‐appearing cells. To characterize electrophysiological properties, we used whole‐cell patch clamp recordings in tissue slices obtained from 42 cases of pediatric CD (ages 0.2–14 years). The pipette contained biocytin for determination of morphological features.

Results: Approximately 25% of recorded cells displayed morphologic differences compared with normal‐appearing pyramidal neurons, and were divided as follows: immature, misoriented, dysmorphic, cytomegalic, and balloon cells. Immature cells displayed electrophysiological membrane properties typical of developing neurons. Misoriented pyramidal neurons and pyramidal neurons with dysmorphic processes displayed properties similar to normal‐appearing pyramidal neurons. In contrast, cytomegalic neurons and balloon cells displayed abnormal membrane properties. Balloon cells had a very high input resistance and lacked voltage‐gated Na+ and Ca2+ currents. Cytomegalic neurons had a very high membrane capacitance, very low input resistance, and showed signs of hyperexcitability, as exemplified by the occurrence of repetitive, slowly inactivating Ca2+ spikes when depolarized.

Conclusions: We suggest that cytomegalic neurons but not balloon cells have the potential to be epileptic generators, although probably not instigators, in severe CD tissue.
Plastic Changes and Disease‐modifying Effects of Scopolamine in the Pilocarpine Model of Epilepsy in Rats
Authors: Pereira Heloísa A. A. , Benassi Simone K. , Mello Luiz E.
Published: June 2005

Summary:  Purpose: We describe the use of a clinically relevant pharmacological intervention that alters the clinical history of status epilepticus (SE)‐induced spontaneous recurrent seizures (SRS) in the pilocarpine model and the possible plastic changes underlying such an effect.

Methods: Two hours after pilocarpine‐induced SE (320–350 mg/kg, i.p.), rats received scopolamine 1–2 mg/kg i.p. or saline, every 6 h for 3 days. After that, osmotic minipumps were implanted for continuous delivery of scopolamine or saline for an additional 14 days. Animals were video‐monitored for 12 h/week during the following 3‐month period for the occurrence of SRS and, thereafter, were perfused, processed, and coronal brain sections were stained for acetylcholinesterase (AChE) and for the presence of supragranular mossy fibers (Timm).

Results: Treatment with scopolamine led to significantly fewer SRS. Staining for AChE in the dentate gyrus was significantly more intense in naïve animals. The scopolamine group had the least intense AChE staining of all groups. However, regression analysis of the AChE staining for this group did not correlate with the presence or absence of SRS, or the latency or frequency of SRS. Supragranular mossy fiber sprouting developed in all animals experiencing pilocarpine‐induced SE, irrespective of whether or not they were treated with scopolamine.

Conclusions: Pilocarpine‐induced SE in the presence of scopolamine might produce animals that, despite mossy fiber sprouting, were not seen to exhibit spontaneous seizures. In addition, our data suggest that the encountered changes in the AChE staining in the dentate gyrus that followed treatment with scopolamine do not help to explain its disease‐modifying effects.
GABA Synapses and the Rapid Loss of Inhibition to Dentate Gyrus Granule Cells after Brief Perforant‐Path Stimulation
Authors: Naylor David E. , Wasterlain Claude G.
Published: June 2005

Summary:  Purpose: To study the pharmacologic and synaptic basis for the early loss of paired‐pulse inhibition that occurs in the perforant‐path stimulation model of status epilepticus.

Methods: Hippocampal slices were prepared from male Wistar rats. Test paired pulses (20‐ to 50‐ms interstimulus interval) of the perforant path were used before and after an abbreviated period of perforant‐path stimulation (1–5 min; 2‐Hz continuous with 20 Hz of 10 s/min pulses) while either recording field potentials from the dentate gyrus granule cell layer or directly measuring whole‐cell patch‐clamp currents from granule cells. Paired‐pulse field recordings also were obtained during perfusion of the γ‐aminobutyric acid (GABA)A antagonist bicuculline.

Results: Prolonged loss of paired‐pulse inhibition occurs after brief (<5 min) perforant‐path stimulation in vitro (similar to results in vivo) with the paired‐pulse population spike amplitude ratio (P2/P1) increasing from a baseline of 0.53 ± 0.29 to 1.17 ± 0.09 after perforant‐path stimulation (p < 0.05). After perfusion with the GABAA antagonist, bicuculline, the P2/P1 ratio also increased from a baseline of 0.52 ± 0.16 to 1.15 ± 0.26 (p < 0.05). After 1–2 min of perforant‐path stimulation, a 22 ± 6% (p < 0.05) decrease occurred in the P2/P1 amplitude ratio of paired‐pulse evoked inhibitory postsynaptic currents.

Conclusions: Similar to in vivo, loss of paired‐pulse inhibition occurs with brief perforant‐path stimulation in vitro. GABAA antagonism causes a similar loss of paired‐pulse inhibition, and the effects of perforant‐path stimulation on postsynaptic inhibitory currents also are consistent with the involvement of GABAA synaptic receptors. The findings suggest that loss of inhibition at GABA synapses may be an important early event in the initiation of status epilepticus.
Programmed Neuronal Necrosis and Status Epilepticus
Authors: Niquet Jerome , Liu Hantao , Wasterlain Claude G.
Published: June 2005

Summary:  We examined the mechanism of neuronal necrosis induced by hypoxia in dentate gyrus cultures or by status epilepticus (SE) in adult mice. Our observations showed that hypoxic necrosis can be an active process starting with early mitochondrial swelling and loss of the mitochondrial membrane potential, followed by cytochrome c release and caspase‐9–dependent activation of caspase‐3. This sequence of events (or program) was independent of protein synthesis and may be induced by energy failure and/or calcium overloading of mitochondria. We called this form of necrosis “programmed necrosis.” After SE in adult mice, CA1 and CA3 pyramidal neurons displayed a necrotic morphology, associated with caspase‐3 immunoreactivity and with double‐stranded DNA breaks, suggesting that “programmed necrosis” may be involved in SE‐induced neuronal loss.
Central‐type Benzodiazepine Receptors and Epileptogenesis: Basic Mechanisms and Clinical Validity
Authors: Morimoto Kiyoshi , Tamagami Hiroshi , Matsuda Kazumi
Published: June 2005

Summary:  Purpose:γ‐Aminobutyric acid (GABA)‐A/benzodiazepine receptors (BZRs) play an important inhibitory role in epileptogenesis. [123I]Iomazenil (123I‐IMZ) is a specific ligand for central‐type (or neuronal‐type) BNRs and is available for single‐photon emission computed tomography (SPECT) in brain disorders. We demonstrated alterations of central‐type BZRs in human focal epilepsies and their experimental models.

Methods: We examined interictal 123I‐IMZ SPECT in patients with mesial temporal lobe epilepsy (MTLE; n = 19) with hippocampal sclerosis and neocortical epilepsy with focal cortical dysplasia (NE‐CD; n = 18), and compared those with magnetic resonance imaging (MRI) and 123I‐IMP SPECT (for regional cerebral blood flow). We also investigated in vitro autoradiography with 123I‐IMZ at various time courses in the intraamygdala kainate, amygdala kindling, and in‐utero irradiation models.

Results: In MTLE patients, the epileptogenic hippocampus often showed decreases in both 123I‐IMZ and 123I‐IMP SPECT. Consistent with those, marked reduction of 125I‐IMZ binding was observed in hippocampal CA1‐3 regions of the kainate model, which clearly paralleled pyramidal neuronal loss. In contrast, 125I‐IMZ binding was increased in the dentate gyrus at 1 month but returned to the normal level at 3–6 months, when frequent spontaneous seizures appeared. The amygdala‐kindling model demonstrated similar increases in 125I‐IMZ binding in the dentate gyrus without any changes in other brain regions. In NE‐CD patients, the epileptogenic foci showed decreased 123I‐IMZ binding with relatively normal 123I‐IMP SPECT. 125I‐IMZ binding also was decreased in the cerebral cortex, hippocampus (areas CA1, 2, and 4), and caudate/putamen of the in‐utero irradiation model.

Conclusions: These results indicate that central‐type BZRs neuroimaging is useful for detection of epileptogenic foci, but their alterations differ between epilepsy subtypes and time‐courses.
Establishment and optimization of a flow cytometric method for evaluation of viability of CD34+ cells after cryopreservation and comparison with trypan blue exclusion staining
Authors: Humpe Andreas , Beck Christian , Schoch Robert , Kneba Michael , Horst Heinz‐August
Published: June 2005

BACKGROUND:  Trypan blue exclusion staining is probably the most frequently applied method (Method I) for assessment of viability in peripheral blood progenitor cell grafts after cryopreservation. Alternatively, a flow cytometry–based method (Method II) was established and optimized.

STUDY DESIGN AND METHODS:  In a first series of 22 autologous apheresis products, the influence of duration of antibody staining and red cell (RBC) lysis on viability was investigated. In a second series of 21 autologous and 1 allogeneic apheresis products, the effect of omitting the RBC lysis was evaluated. On the basis of the results of the first two series, 155 autologous and 57 allogeneic apheresis products were analyzed with Method I and the now optimized Method II.

RESULTS:  Halving the incubation times did not influence the viability of CD45+ or CD34+ cells. Omission of RBC lysis resulted in a significantly (p = 0.022) increased median viability of CD45+ cells (75.8% vs. 71.0%) without any influence on CD34+ cells. In the third series, the median viability of CD34+ cells (96.9%) was significantly (p < 0.0001) higher compared with the viability of CD45+ cells (76.2%) and the viability determined by Method I (86.5%).

CONCLUSION:  The viability of CD34+ cells was significantly higher compared with the viability of all white blood cells. The presented cytometry‐based method is superior to the standard trypan blue method regarding the number of analyzable cells and documentation, regarding observer independence and standardization; it allows the analysis of the cells of interest for transplantation after minimal sample manipulation.
Alleviating blood shortages in a resource‐constrained environment
Authors: Pitocco Christine , Sexton Thomas R.
Published: June 2005

BACKGROUND:  The nation devotes considerable resources to the collection, processing, and distribution of blood products. Nonetheless, shortages of virtually every blood component persist. Economic theory suggests that the national blood supply can be increased either by increasing the level of resources used in the collection and production of blood components or by utilizing existing resources more efficiently.

STUDY DESIGN AND METHODS:  This study uses data envelopment analysis to analyze the efficiency of 70 blood centers to determine the extent to which operational efficiency can be improved, the increase in the nation's blood supply that would result, and management strategies that would lead to such improvements. Data were collected from the AABB 2002‐2003 Directory of Community Blood Centers.

RESULTS:  The study found that roughly half of the 70 blood centers studied are efficient. The remaining blood centers collectively can both increase outputs and decrease some inputs. If the inefficient blood centers were to eliminate half of their inefficiency, then systemwide output of platelets would be increased by 17 percent, cryoprecipitate by 12 percent, plasma by 10 percent, and red blood cells by 7 percent. Inefficient blood centers have little opportunity to reduce full‐time employees or reduce expenditures; however, they can decrease their use of part‐time employees by 10 percent and volunteers by 9 percent.

CONCLUSION:  The results indicate that efficiency improvements would help to alleviate the nation's persistent blood shortages. These findings can be used by blood center managers to identify management interventions that can improve operational efficiency, resulting in greater output with existing levels of resources.