bluuebunny/crossref_metadata_2025 huggingface dataset:
Cinemas of Empire
Authors: Chapman James
Published: July 2006

This article surveys the subject of ‘Cinemas of Empire’ from the 1930s to the present. It discusses the role of the American and British cinemas in promoting an ideology of popular imperialism during the 1930s and how the genre of ‘imperial film’ was modified in response to political and cultural determinants during and after the Second World War as it came to terms with the retreat from empire. It then considers the emergence of a radical anti‐colonialist cinema in the Third World during the 1960s. It concludes by showing how postcolonial discourse has informed the national cinemas of Australia, Ireland and India in recent decades.
Women's perception of sexuality during pregnancy and after birth
Authors: Gerda TRUTNOVSKY , Josef HAAS , Uwe LANG , Edgar PETRU
Published: July 2006

Background:  Pregnancy and birth mark a distinct period in the life of a woman. Hormonal alterations and bodily and social changes impact on women's physical well‐being, mood, relationship and sexuality. Most existing research on sexuality during pregnancy focuses on the quantitative analysis of sexual activities, but neglects subjective experiences of women.

Aims:  To examine women's sexual needs, sexual activities, subjective importance of sexuality and contentment with sex life, focusing on the changes over the course of pregnancy and post‐partum.

Methods:  Twenty‐six women completed a series of three extensive interviews in early and late pregnancy, as well as 6 months post‐partum. A semiqualitative approach, combining visual analogue scales and a semistructured interview with self‐developed questions, was used.

Results:  The statistical analysis revealed a significant decrease of perceived ‘importance of sexuality’, ‘importance of sexual intercourse’ and ‘contentment with present sex life’, from prepregnancy over early pregnancy to late pregnancy, which was followed by a slight increase in the post‐partum period. Samples from the structured interviews provide a detailed insight into female experiences, perceptions and opinions, and demonstrate the high interindividual variability.

Conclusion:  Doctors can provide invaluable advice to women regarding the psychosexual changes and help them to understand the normal fluctuations in sexual interest during pregnancy and the post‐partum.
After the FLUSH trial: A prospective observational study of lipiodol flushing as an innovative treatment for unexplained and endometriosis‐related infertility
Authors: BRENT Kira , HADDEN Wendy E. , WESTON‐WEBB Marianne , JOHNSON Neil P.
Published: July 2006

Objectives:  To assess the demographics, efficacy and safety of lipiodol flushing fertility treatment.

Design:  Prospective observational study.

Setting:  Secondary level care infertility clinic and radiology centre based in Auckland, New Zealand.

Population:  The first cohort of 100 New Zealand women with infertility to undergo lipiodol flushing as an innovative fertility treatment.

Methods:  Women received lipiodol flushing performed by a hysterosalpingogram technique and were followed up at 6 months.

Main outcome measures:  Clinical pregnancy at 6 months post‐treatment; and live birth or ongoing pregnancy.

Results:  The overall pregnancy rate was 30% and the live birth or ongoing pregnancy rate 27%. For women under 40 years old, a 32% pregnancy rate and a 25% live birth or ongoing pregnancy rate were seen in women with unexplained infertility, and a 50% pregnancy rate and a 47% live birth or ongoing pregnancy rate were seen in women with endometriosis. Of women aged 40 years and older, the pregnancy rate was 13% and the live birth or ongoing pregnancy rate was 13%. The pregnancy rates included those occurring after additional interventions, such as intrauterine insemination and in vitro fertilisation, accounting for 12 of the 30 pregnancies. There were no treatment complications.

Conclusion:  This study provides further evidence of the efficacy and safety of lipiodol flushing fertility treatment.
Survey of Australasian clinicians’ prior beliefs concerning lipiodol flushing as a treatment for infertility: A Bayesian study
Authors: JOHNSON Neil P. , FISHER Rosalie A. , BRAUNHOLTZ David A. , GILLETT Wayne R. , LILFORD Richard J.
Published: July 2006

Objective:  To evaluate clinicians’ beliefs concerning the effectiveness of lipiodol flushing as a treatment for unexplained infertility, and to integrate these prior beliefs with evidence from randomised trials.

Design:  Survey.

Setting:  Specialists in Australasian in vitro fertilisation (IVF) clinics in 2001.

Methods:  One of two types of structured survey was used to gather information from fertility specialists in Australasian IVF clinics. Prior beliefs were captured graphically and textually from responses.

Results:  Nineteen specialists returned questionnaires. Eighteen of the 19 specialists believed that lipiodol flushing was more likely to be beneficial than harmful. The most widely held prior belief, reflected in both textual and numerical responses, was that lipiodol was likely to produce a small beneficial response. The credible limits of this belief were compatible with a reasonable fertility benefit, as more than 50% believed that a 1.5‐fold increase in pregnancy rate was plausible. The two surveys found that a 1.2‐fold or 1.4‐fold increase in pregnancy rate was the median expected level of benefit at which clinicians would have been inclined to recommend lipiodol flushing to their patients (combined range 1.1‐ to 2.3‐fold) – new evidence suggests that for women with endometriosis but otherwise unexplained infertility, these levels of benefit are exceeded.

Conclusions:  Among Australasian fertility specialists there is variation in prior beliefs concerning the effectiveness of lipiodol flushing as a treatment for unexplained infertility and in the expected level of benefit at which clinicians are inclined to recommend this treatment. Generalisability of these beliefs remains uncertain owing to a low study response rate.
Birth outcomes for teenage women in New South Wales, 1998–2003
Authors: ROBSON Stephen , CAMERON Carolyn A. , ROBERTS Christine L.
Published: July 2006

Background:  Pregnancy and childbirth in teenage women are associated with obstetric and social risks, and there is evidence that the birth rate among teenagers in rural and remote areas of Australia is not in decline. The combination of non‐urban residence and young age at delivery might define a subgroup of women at special risk of adverse birth outcomes.

Aims:  To compare birth outcomes of New South Wales (NSW) teenagers residing in rural and remote areas with those living in larger centres with greater access to services.

Methods:  Outcomes for all singleton deliveries to teenage women living in NSW during the period 1998–2003 were reviewed. The women's place of residence was assigned an ARIA (Accessibility/Remoteness Index of Australia) classification according to remoteness and access to services. Analysis included obstetric factors (such as parity), and smoking status. Logistic regression analysis was undertaken to examine the impact of maternal factors on obstetric outcomes.

Results:  During the study period, 21 880 teenage women had singleton deliveries. Babies of teenage mothers in very remote areas had higher rates of preterm birth, small‐for‐gestational age and stillbirth. Rates of smoking were higher in more remote areas, and smoking correlated with preterm birth and stillbirth.

Conclusions:  Teenagers living in remote areas of NSW face a higher risk of adverse pregnancy outcomes than their urban cousins.
End‐of‐life experience of demented elderly patients at home: findings from DEATH project
Authors: HIRAKAWA Yoshihisa , MASUDA Yuichiro , KUZUYA Masafumi , KIMATA Takaya , IGUCHI Akihisa , UEMURA Kazumasa
Published: July 2006

Background:  As the number of demented elderly patients choosing to die at home continues to rise, it is important to ascertain how cognitive impairment is associated with symptom experience and end‐of‐life care received at home. A number of studies have suggested that patients with dementia often receive poor end‐of‐life care, with inadequate pain or other symptom control, so far however, very little research has dealt with community settings. The aim of the present study is to compare symptom experience and end‐of‐life care received by home patients based on cognitive function.

Methods:  The present data was obtained from the Dying Elderly at Home (DEATH) project, a multicenter observational study conducted in Japan. The following information was collected: decedent characteristics, observed symptoms and end‐of‐life care provided during the last 48 h of life. A total of 98 decedents with dementia and 112 decedents without dementia were included in the analysis. To assess the differences in characteristics and clinical course among decedents, the survey data was divided into two groups: dementia and non‐dementia.

Results:  Demented decedents were prone to incontinence or cough, but experienced relatively little pain, nausea and vomiting. Demented decedents were given more antibiotics but less opioids than non‐demented decedents. Also, they received a larger volume of intravenous infusion at 24–48 h before death. After controlling for age and other differences in baseline characteristics, dementia was determined to be a significant independent predictor of incontinence or uncontrolled pain. After controlling for age, other differences in baseline characteristics and symptom experience, dementia was determined not to be a significant independent predictor of use of antibiotics or opioids.

Conclusions:  Our findings suggest that dementia itself was an independent predictor of incontinence or less pain, and that it was not a significant independent predictor of use of end‐of‐life in a home setting.
Features of elderly patients admitted to a general hospital psychiatric unit
Authors: FURUKAWA Yoshiko , ODAWARA Toshinari , YAMADA Yasuhiro , FUJITA Jyunichi , HIRAYASU Yoshio
Published: July 2006

Background:  Improved management of elderly psychiatric patients requires further identification of their special needs and problems.

Methods:  We analyzed the characteristics of 1333 consecutive patients admitted to the Psychiatric Center of Yokohama City University Medical Center, a general hospital psychiatric unit, from January 2000 to December 2003. Patients 65 years old or older (the elderly group) accounted for 12.3% of all patients.

Results:  The duration of admission in elderly patients was significantly longer than in younger patients (less than 65 years old). Admission history and admission type were significantly different between these two groups. Prevalence of dementia or delirium as a primary or secondary diagnosis was significantly greater in the elderly group. About three‐quarters of elderly patients were diagnosed as having a mood disorder (47.6%), or an organic mental disorder (31.1%). A significantly smaller fraction of patients were placed in seclusion in the elderly group than in the younger group, although the fraction of patients who were restrained did not differ between the two groups. A significantly higher fraction of elderly patients was transferred to general medical or surgical wards in the hospital to continue treatment for physical illness. In the elderly group, physical and mental prognoses were poorest in patients with organic mental disorders.

Conclusions:  Compared with the younger patients, the elderly psychiatric patients showed peculiar features. They were thought to require the treatments that were adapted to meet their needs.
Influence of the FDA Talk Paper upon the use of atypical antipsychotics for psychotic symptoms in older patients with dementia in Japan
Authors: FUKUDA Koji , TANAKA Makoto
Published: July 2006

Background:  Atypical antipsychotic medications have often been used in the treatment of behavioral and psychological symptoms of dementia (BPSD). Recently, the US Food and Drug Administration (FDA) issued new safety information concerning atypical antipsychotic drugs, indicating that their use may increase the risk of cardiovascular adverse events among elderly adults with BPSD. Based on this information, the Japanese Ministry of Health, Labor and Welfare issued a similar warning against the use of atypical antipsychotic drugs licensed in Japan. We then sought to determine whether or not the use of typical antipsychotics should be recommended to replace atypical antipsychotics. In this paper, we discuss the influence of these warnings on the withholding of use of risperidone exemplified in seven case histories.

Methods:  Seven inpatients who exhibited BPSD received risperidone monotherapy in our hospital. In response to the FDA notice, the atypical antipsychotics used to treat these patients were replaced with typical antipsychotic agents.

Results:  During the period of risperidone administration, all patients exhibited clinical improvement compared with their baseline results and showed no adverse events. Two of our seven patients developed psychotic exacerbation and exhibited extrapyramidal symptoms coinciding with the replacement of risperidone with conventional antipsychotics.

Conclusion:  To the best of our knowledge, this is the first clinical report on the influence of the FDA alert on the use of atypical antipsychotics for psychotic symptoms in older patients with dementia in Japan. In two of our seven BPSD cases, there was no benefit from taking conventional antipsychotics. Our results lead to the conclusion that the use of typical antipsychotics should not be recommended to replace atypical antipsychotics. Although close attention should be paid to the FDA alert, clinicians must take into consideration the balance of benefits and risks when evaluating the appropriate use of antipsychotics in older patients with dementia.
Biomarkers in Migraine: Their Promise, Problems, and Practical Applications
Authors: Loder Elizabeth , Rizzoli Paul
Published: July 2006

Biomarkers are physical signs or laboratory measurements that “occur in association with a pathological process and have putative diagnostic and/or prognostic utility.” Biomarkers hold considerable promise for understanding and intervening in the disease process of migraine. They may permit recognition of individuals at risk of developing migraine, improve the timing, accuracy, and precision of migraine diagnosis, and serve as indicators of treatment response and disease progression. Furthermore, they hold great promise for research. At the same time, there are important limitations to the use of biomarkers in migraine, including problems with validity, reliability, accuracy, and precision. Legal, ethical, and cost considerations are also important. This review describes the potential uses and limitations of biomarkers in migraine diagnosis, treatment, and research.
Cerebrospinal Fluid Biomarkers in Primary Headache Disorders
Authors: Harrington Michael G.
Published: July 2006

Objective.—The object of this review is to examine the published literature for cerebrospinal fluid laboratory measures of primary headache disorders to identify biomarkers and provide recommendations for future biomarker discovery.

Background.—Biomarkers may distinguish deviation from a normal state, provide insight into mechanisms of pathophysiology, quantify the degree of change, discriminate what may be clinically overlapping disorders, and allow monitoring and/or selection of specific treatment. High‐throughput, discovery technologies fuel the ability to reveal more biomarkers than past hypothesis‐driven studies.

Design or Methods.—Publications were identified in PubMed, ISI web of knowledge (both Web of Science and BIOSYS), and SciFinder, using the key words for cerebrospinal fluid (CSF) and migraine, headache, or biomarkers. Additional references were sought from the papers identified in these searches. Data were assessed relating to all primary headache types for clinical and scientific methods and results.

Results.—Fifty‐five out of 82 biomarkers were found from 55 publications, though none have been validated for clinical utility. Data for site (ventricular, cervical, lumbar) and timing of CSF collection, headache state, and diagnostic description were patchy, and controls were often poorly defined. Most routinely performed CSF measurements were within normal limits. Most levels of pain‐related molecules were reduced, and concentrations of most neurotransmitters, neuropeptides, proteins, and small molecules were increased. Though few studies assessed the specificity of biomarkers for primary headaches, it is clear that there are differences in CSF biomarkers between migraine, cluster headache, tension‐type headache, and trigeminal neuralgia.

Conclusions.—The high proportion (67%) of biomarkers identified from laboratory measures tested thus far predicts that many more biomarkers will be identified for primary headaches when more candidates are evaluated. In order to discover and evaluate more biomarkers, especially those that may have clinical application for headache management, 3 recommendations are encouraged: prospective design of care‐independent studies; evaluation of more clinical variables; and evaluation of substantially more candidates by using discovery‐based research methods. Outlines of approaches to pursue these aims are proposed.
Migrainous Vertigo: Mutation Analysis of the Candidate Genes CACNA1A, ATP1A2, SCN1A, and CACNB4
Authors: Von Brevern Michael , Ta Nga , Shankar Anupama , Wiste Anna , Siegel Anne , Radtke Andrea , Sander Thomas , Escayg Andrew
Published: July 2006

Background.—Migrainous vertigo (MV) is increasingly recognized as a common cause of episodic vertigo. MV displays several clinical similarities with familial hemiplegic migraine (FHM) and episodic ataxia type 2 (EA‐2), which have been linked to mutations in 3 genes, CACNA1A, encoding a neuronal calcium channel α subunit, ATP1A2, encoding a catalytic subunit of a Na+/K+‐ATPase, and most recently the voltage‐gated sodium channel SCN1A. The present study explored the hypothesis that mutations in CACNA1A, ATP1A2, SCN1A, and the calcium channel β4 subunit CACNB4 confer susceptibility to MV.

Methods.—Mutation analysis of the coding exons and exon/intron junctions of CACNA1A, ATP1A2, SCN1A, and CACNB4 was performed in 14 unrelated MV patients by conformation sensitive gel electrophoresis and automated sequence analysis.

Results.—Analysis of the 4 candidate genes in the 14 MV patients resulted in the identification of a total of 26 sequence variants. The silent substitution D29D in CACNB4 was observed in 2 MV patients and was not present in 46 ethnically matched control DNA samples. The remaining variants were also observed in control DNA samples and the allele frequencies of variants that resulted in amino acid substitutions were not significantly different between patients and controls.

Conclusions.—Based on this group of patients there is no evidence that the genes causing FHM and EA‐2 represent major susceptibility loci for MV.
From Transformed Migraine to Episodic Migraine: Reversion Factors
Authors: Seok Jung Im , Cho Hyung In , Chung Chin‐Sang
Published: July 2006

Objective.—To identify the factors contributing to the reversion of transformed migraine (TM) into episodic migraine.

Background.—TM, the most common and important subtype of chronic daily headache (CDH), has a great effect on a patient's quality of life. However, its clinical course and outcome predictors have rarely been studied prospectively.

Method.—Of 1142 consecutive headache patients seen at the Headache Clinic of the Samsung Medical Center, the patients with TM (frequency >15/month for >6 months and a history of migraine meeting the ICHD‐II diagnostic criteria) were followed for at least 1 year. We analyzed the demographic data, clinical course, and compliance factors, such as those of the physician's management protocol and recommended lifestyle modification.

Results.—A total of 136 patients finished the final follow‐up assessment 1 year after the initial evaluation. Ninety‐five patients (70%) converted from TM to episodic migraine. Forty‐one patients (30%) continued to suffer daily headaches without a period of improvement. The demographic and clinical information collected before the treatment was not significantly related to outcome, except for chronic use of analgesics for other medical conditions (P= .01). Of the compliance factors, good compliance with preventive medication (P < .001), withdrawal from continuous use of analgesics for headache relief (P < .001), and regular exercise (P= .04) were significant positive contributors to the reversion of TM into episodic migraine.

Conclusion.—Compliance factors are the most important factors that determine the reversion of TM into episodic migraine.
Cerebral Vasoreactivity is Influenced by the Prandial State Among Migraineurs
Authors: Coelho Rodolfo de S. , Gomes Ciro M. , Teixeira Ricardo A.
Published: July 2006

Objective.—To test if the cerebral vasoreactivity among migraineurs is influenced by the prandial state.

Design and Methods.—Eight patients with migraine without aura were studied (mean age = 23.75 years; range = 19 to 32 years; 6 women). We also studied 8 healthy controls (mean age = 20.63 years; range = 18 to 22 years; 3 women), with no history of migraine. Cerebral vasoreactivity was measured on the right side by the breath holding index (BHI) using an EZ‐Dop transcranial Doppler instrument, with a 2‐MHz transducer fitted on a headband. Serum glucose levels were measured after a 10‐hour fasting period and then 10 minutes after a standardized breakfast.

Results.—In both groups, we found a postprandial (PP) glycemia enhancement (P < .02). Migraineurs showed enhanced PP cerebral vasoreactivity when compared to the fasting state (FS) (BHI‐PP = 1.46; BHI‐FS = 1.16; P= .02). Among controls, we found a trade to enhancement, but without statistic significance (BHI‐PP = 1.28; BHI‐FS = 1.11; P= .30). Glucose levels were not significantly correlated to cerebral vasoreactivity in any of the groups (P > .05).

Conclusion.—Our findings suggest that migraineurs have a higher reactivity to hypercapnia during the PP period.
Melatonin Responsive Hemicrania Continua
Authors: Rozen Todd D.
Published: July 2006

Hemicrania continua is one of the indomethacin‐responsive headache syndromes. There are very few effective alternative therapies for hemicrania continua, thus patients may require daily indomethacin for years. The risks of long‐term indomethacin include gastrointestinal and renal dysfunction. Melatonin is a pineal hormone with a chemical structure very similar to indomethacin. Recently, melatonin was shown to be effective for primary stabbing headache, another indomethacin‐responsive syndrome. Three cases of melatonin responsive hemicrania continua are now reported.
Decreased Dopamine D2/D3‐Receptor Binding in Temporal Lobe Epilepsy: An [18F]Fallypride PET Study
Authors: Werhahn Konrad J. , Landvogt Christian , Klimpe Sven , Buchholz Hans‐Georg , Yakushev Igor , Siessmeier Thomas , Müller‐Forell Wibke , Piel Markus , Rösch Frank , Glaser Martin , Schreckenberger Mathias , Bartenstein Peter
Published: July 2006

Summary:  Purpose: Although animal data are suggestive, evidence for an alteration of the extrastriatal dopaminergic system in human focal epilepsy is missing.

Methods: To quantify D2/D3‐receptor density, we studied seven patients with temporal lobe epilepsy (TLE) and nine age‐matched controls with positron emission tomography (PET) by using the high‐affinity dopamine D2/D3‐receptor ligand [18F]Fallypride ([18F]FP) suitable for imaging extrastriatal binding. TLE was defined by interictal and ictal video‐EEG, magnetic resonance imaging (MRI), and [18F]fluorodeoxyglucose ([18F]FDG)‐PET and was due to hippocampal sclerosis (HS), based on histology in all patients. Primary analysis was based on regions of interest (ROIs) defined on individual MRIs. For each patient, binding potential (BP) was calculated by using the simplified reference tissue model, and the epileptogenic was compared with the unaffected hemisphere in each ROI. To confirm the results, an additional voxel‐based group analysis was performed by using statistical parametric mapping.

Results: Compared with controls, [18F]FP BP was significantly decreased in the epileptogenic temporal lobe in all patients. On ROI analysis, this reduction was evident in areas surrounding the seizure‐onset zone at the pole (–34.2%) and lateral aspects (–32.9%) of the temporal lobe. Although the hippocampus [18F]FDG uptake (–8.1%) and hippocampal MR volume (–35.1%) were significantly reduced, no significant decrease of [18F]FP BP was found. Reduction of [18F]FP BP did not correlate with hippocampal atrophy.

Conclusions: D2/D3‐receptor binding is reduced at the pole and in lateral aspects of the epileptogenic temporal lobe in patients with mesial TLE and HS. This area might correspond to “the irritative zone,” indicating that D2/D3 receptors might play a specific role in the pathophysiology of mesial TLE.
Speech Recognition Impairments in Patients with Intractable Right Temporal Lobe Epilepsy
Authors: Boatman Dana F. , Lesser Ronald P. , Crone Nathan E. , Krauss Gregory , Lenz Frederick A. , Miglioretti Diana L.
Published: July 2006

Summary:  Purpose: To evaluate speech recognition in patients with focal intractable epilepsy and surgical resections in the nondominant (right) hemisphere.

Methods: Speech recognition was tested prospectively, under different listening conditions, in 22 patients with right temporal lobe (11 patients) or extra–temporal lobe epilepsy. All were left‐hemisphere dominant for language on preoperative intracarotid sodium amobarbital testing.

Results: All patients demonstrated normal auditory recognition of words and environmental sounds before and after surgery. However, when real‐world listening conditions were simulated by using acoustically degraded (filtered) words, patients with temporal lobe epilepsy performed significantly worse than patients with frontal or parietooccipital lobe epilepsy before and after surgery (p < 0.0001).

Conclusions: Patients with intractable right temporal lobe epilepsy are at risk for speech recognition impairments in real‐world listening environments, independent of surgery. The impact of speech recognition difficulties on verbal communication, coupled with the prevalence of adverse listening environments, underscores the importance of testing speech recognition under different listening conditions in patients with intractable right temporal lobe epilepsy.
Extratemporal White Matter Abnormalities in Mesial Temporal Lobe Epilepsy Demonstrated with Diffusion Tensor Imaging
Authors: Gross Donald W. , Concha Luis , Beaulieu Christian
Published: July 2006

Summary:  Purpose: Recent studies have demonstrated bilateral white matter abnormalities in temporal lobe epilepsy (TLE) patients with unilateral mesial temporal sclerosis (MTS). The purpose of this project was to determine whether abnormalities of water diffusion are seen in extratemporal white matter of patients with TLE and pathologically confirmed MTS and to determine whether these findings are associated with worse surgical outcome.

Methods: Eleven patients with TLE and unilateral MTS confirmed in surgical specimens and 14 controls were studied by using cerebrospinal fluid–suppressed diffusion tensor imaging (DTI) and T2 relaxometry.

Results: Hippocampal T2 signal for patients was significantly elevated both ipsilateral (p < 0.001) and contralateral (p = 0.006) to MTS. DTI demonstrated reduced fractional anisotropy of the genu of the corpus callosum (p = 0.003) and external capsule (p = 0.02) and elevated mean diffusivity of the genu (p = 0.005), splenium (p = 0.03), and external capsule (p < 0.001). For both the genu and external capsule, parallel diffusion of patients was not different from that of controls (genu, p = 0.81; external capsule, p = 0.45), whereas perpendicular diffusion was elevated (genu, p = 0.001; external capsule, p < 0.001). With mean postsurgical follow‐up of 18.5 months, eight of 11 patients were entirely seizure free and the remaining three had all experienced a worthwhile reduction in seizure frequency.

Conclusions: Our findings suggest that although patients with TLE and MTS have extensive bilateral and extratemporal pathology, these findings may not be associated with a worse postsurgical outcome.
Hippocampal Kindling Leads to Motor Map Expansion
Authors: Van Rooyen Francine , Young Nicole A. , Larson Sarah E. M. , Teskey G. Campbell
Published: July 2006

Summary:  Purpose: To determine whether seizure activity, repeatedly elicited in the hippocampus, could alter the functional organization of neocortical movement representations (motor maps) and whether a relation exists between the number of afterdischarges recorded in the sensorimotor neocortex and the size of the motor maps.

Methods: We electrically kindled the right ventral hippocampus of Long–Evans hooded rats, twice daily, for 40 sessions and recorded the afterdischarges in the stimulated hippocampus and right sensorimotor neocortex. Between 3 and 7 days after the last seizure, we used high‐resolution intracortical microstimulation to derive the forelimb‐movement representations in the left (un‐implanted) sensorimotor neocortex.

Results: In the hippocampal kindled rats, we observed a dramatic expansion of the area of neocortex that would elicit forelimb movements compared with sham‐kindled controls. The number of afterdischarges recorded in the neocortex was significantly and positively correlated with the size of the motor maps.

Conclusions: Seizures propagating from the hippocampus have long‐distance effects on the functional organization of motor maps.
Volumetric Evidence of Bilateral Damage in Unilateral Mesial Temporal Lobe Epilepsy
Authors: Araújo David , Santos Antônio C. , Velasco Tonicarlo R. , Wichert‐Ana Lauro , Terra‐Bustamante Vera C. , Alexandre Veriano , Carlotti Carlos G. , Assirati João A. , Machado Hélio Rubens , Walz Roger , Leite João P. , Sakamoto Américo C.
Published: July 2006

Summary: Purpose:We sought to analyze the contralateral volumes of the temporal pole, posterior segment of the temporal lobe, amygdala, hippocampus, and parahippocampal gyrus in patients with temporal lobe epilepsy (TLE) due to histologically proven mesial temporal lobe sclerosis (MTLS), seizure free for ≥4 years of postsurgical follow‐up.

Methods:Forty‐six (23 male) TLE patients, operated on between 1996 and 2001, with histopathologic diagnosis of MTLS, and a postsurgical follow‐up of ≥4 years, had their temporal lobe structures manually segmented, measured, and compared with those of 23 normal volunteers, paired as groups for sex, age, and handedness.

Results:The mean volumes of the contralateral temporal pole, hippocampus, and parahippocampal gyrus in TLE patients were significantly lower than those in controls.

Conclusions:MRI volumetric data show that the damage in TLE due to MTS may be more widespread and bilateral, even in patients with unilateral TLE by clinical and neurophysiological criteria. Our results are relevant to the discussion of epileptogenic mechanisms in TLE.
Surgical Treatment for Refractory Temporal Lobe Epilepsy in the Elderly: Seizure Outcome and Neuropsychological Sequels Compared with a Younger Cohort
Authors: Grivas Athanasios , Schramm Johannes , Kral Thomas , Von Lehe Marec , Helmstaedter Christoph , Elger Christian E. , Clusmann Hans
Published: July 2006

Summary: Purpose:Surgical treatment of refractory temporal lobe epilepsy (TLE) is promising for selected patients, but only little experience has been acquired in operating on older patients, especially with limited resections. We intend to delineate clinical and surgical factors influencing outcome in patients older than 50 years at operation and to compare the results with those of a younger patient cohort.

Methods:Fifty‐two patients older than 50 years were operated on for intractable mesial or combined mesiolateral TLE between 1991 and 2002. The mean age at operation was 55 years, and the mean duration of epilepsy was 33 years. Forty selective amygdalohippocampectomies (33 for hippocampal sclerosis, seven for removal of a mesiotemporal lesion), five lateral temporal lesionectomies plus amygdalohippocampectomy, and seven anterior temporal lobectomies were performed. Eleven (21%) patients had undergone invasive presurgical video‐EEG monitoring. The mean follow‐up period was 33 months. We compared the results with those of a younger cohort operated on in the same time period.

Results:Thirty‐seven older patients attained complete seizure control (71% class I), and 10 patients had only rare postoperative seizures (19% class II). Four patients improved >75% (8% class III), and one patient did not improve (2% class IV). The same rate of seizure control was attained by 11 patients older than 60 years at surgery. These results were not significantly different from those in a younger patient group. A trend toward better seizure control was noted in 16 patients with an epilepsy duration of <30 years (all class I or II), and in 20 patients with a seizure frequency of fewer than five seizures per month (all class I or II). No mortality resulted from a total of 65 diagnostic and therapeutic procedures. A 3.8% permanent neurologic morbidity (dysphasia and hemiparesis) was noted. Hemianopia occurred in three (5.9%) patients. Neuropsychological testing revealed low preoperative performances and some gradual further deterioration after surgery.

Conclusions:Results of surgery for TLE with mainly limited resections are promising in patients older than 50 years and older 60 years, despite the long seizure history. As expected, the risk of complications is somewhat higher compared with that in a younger control group. The impact of low neuropsychological performance is a concern.
Musicogenic Seizures Can Arise from Multiple Temporal Lobe Foci: Intracranial EEG Analyses of Three Patients
Authors: Tayah Tania F. , Abou‐Khalil Bassel , Gilliam Frank G. , Knowlton Robert C. , Wushensky Curtis A. , Gallagher Martin J.
Published: July 2006

Summary: Purpose:To determine the ictal‐onset zone of musicogenic seizures by using intracranial EEG monitoring.

Methods:Musicogenic seizures in three patients with medically intractable musicogenic epilepsy were first localized by using noninvasive methods including, in one patient, ictal magnetoencephalography (MEG) and magnetic resonance spectroscopy (MRS). The ictal‐onset zones in these patients were then further localized using by intracranial EEG monitoring, and the outcomes of the two patients who underwent epilepsy surgery were determined.

Results:Patient 1's musicogenic seizures localized to the right lateral temporal lobe, patient 2's originated in the right mesial temporal lobe, and patient 3's arose independently from both mesial temporal lobes. Patients 1 and 2 underwent resective epilepsy surgery and are seizure free (Engel class I).

Conclusions:Musicogenic epilepsy is a heterogeneous syndrome with seizures that can arise from multiple temporal lobe foci. Patients with medically intractable musicogenic epilepsy and with unilateral ictal onset zones may be considered candidates for resective epilepsy surgery.
Oxidized, bioactive implants are rapidly and strongly integrated in bone. Part 1 – experimental implants
Authors: Sul Young‐Taeg , Jeong Yongsoo , Johansson Carina , Albrektsson Tomas
Published: July 2006

Objectives: The study presented was designed to investigate the speed and the strength of osseointegration of oxidized implants at early healing times in comparison which machined, turned implants.

Material and methods: Screw‐shaped titanium implants were prepared and divided into two groups: magnesium ion incorporated, oxidized implants (Mg implants, n=10) and machined, turned implants (controls, n=10). Mg implants were prepared using micro‐arc oxidation methods. Surface oxide properties of implants such as surface chemistry, oxide thickness, morphology/pore characteristics, crystal structures and roughness were characterized with various surface analytic techniques. Implants were inserted into the tibiae of ten New Zealand white rabbits. After a follow‐up period of 3 and 6 weeks, removal torque (RTQ), osseointegration speed (ΔRTQ/Δhealing time) and integration strength of implants were measured. Bonding failure analysis of the bone‐to‐implant interface was performed.

Results: The speed the and strength of osseointegration of Mg implants were significantly more rapid and stronger than for turned implants at follow‐up periods of 3 and 6 weeks. Bonding failure for Mg implants dominantly occurred within the bone tissue, whereas bonding failure for turned implants mainly occurred at the interface between implant and bone.

Conclusions: Oxidized, bioactive implants are rapidly and strongly integrated in bone. The present results indicate that the rapid and strong integration of oxidized, bioactive Mg implants to bone may encompass immediate/early loading of clinical implants.
Characterization of human bone cells derived from the maxillary alveolar ridge
Authors: Clausen Christian , Hermund Niels Ulrich , Donatsky Ole , Nielsen Henrik
Published: July 2006

Abstract: In this study, we have characterized bone cell cultures derived from the human maxillary alveolar ridge, which could be a potential cell source for tissue engineering of the severely resorbed maxilla. From 10 individuals, an osseous core was obtained. Without the use of collagenase, 10 explant cultures were established and the morphology of the cells (human maxilla‐derived cells (hMDCs)) was studied with light microscopy (LM). Explant cultures were analyzed by flow cytometry with respect to size, granularity and surface marker expression. Fluorochrom‐conjugated monoclonal antibodies (CD13, CD31, CD44, CD90 or CD73) were used. hMDCs were cultured in standard medium (SCM) or osteoinductive medium (OIM) for 21 days and analyzed for the presence of alkaline phosphatase (ALP) and calcium deposits (Von Kossa). Furthermore, osteogenic gene expression (osteocalcin [OC], ALP, collagen type 1) were analyzed by reverse transcription polymerase chain reaction (RT‐PCR). LM demonstrated that hMDCs had a polygonal morphology containing a central nucleus with two to three nucleoli. Size/granularity analysis revealed differences between individuals. Immunophenotypically, these cells were positive for CD13, CD44, CD90 and CD73 while negative for CD31. Cells cultured in SCM for 21 days showed moderate ALP staining and many calcium deposits. Culturing cells in OIM for 21 days significantly increased both ALP staining and the number of calcium deposits. RT‐PCR demonstrated expression of osteogenic marker genes and the ability to upregulate osteocalcin and ALP in response to osteogenic inducers. To our knowledge, it is the first time that surface marker expression has been studied on bone cells originating from this site. Cells were positive for markers characteristic for immature mesenchymal stem cells and had osteogenic differentiation capability. This study indicates that cells derived from maxillary biopsies could be a potential cell source for bone tissue engineering.
German short forms of the Oral Health Impact Profile
Authors: John Mike T. , Miglioretti Diana L. , LeResche Linda , Koepsell Thomas D. , Hujoel Philippe , Micheelis Wolfgang
Published: July 2006

Abstract –  Objectives:  We report the development and psychometric evaluation of short forms of the Oral Health Impact Profile German version (OHIP‐G) ‐ an instrument to assess oral health‐related quality of life (OHRQoL).

Methods:  A five‐item short form was developed using best subset regression in 2050 subjects from a national survey. Two 14‐item versions were derived from English‐language short forms and a 21‐item version from previous factor analytic work. A second sample from the general population (n = 163) and a sample of clinical patients with temporomandibular disorders (TMD; n = 175) were used to investigate validity and internal consistency. Test‐retest reliability was evaluated in 30 prosthodontic patients before treatment. Responsiveness was assessed in 67 patients treated for their TMD pain.

Results:  Associations between short form summary scores and self‐report of oral health and four oral disorders in the general population and in TMD patients were interpreted as support for convergent/groups validity. The instruments’ responsiveness (effect measures of 0.55–0.98), test‐retest reliability (intraclass correlation coefficients: 0.72–0.87), and internal consistency (Cronbach's alpha: 0.65–0.92) were sufficient.

Conclusions:  Sufficient discriminative and evaluative psychometric properties of short forms of the OHIP‐G make the instruments suitable to assess OHRQoL in cross‐sectional as well as longitudinal studies.
A community study on the relationship between stress, coping, affective dispositions and periodontal attachment loss
Authors: Ng Sam K. S. , Keung Leung W.
Published: July 2006

Abstract –  Background:  Psychological factors may increase the risk for periodontal diseases. Contemporary conceptualization of the stress process supports the evaluation of stress at three levels: stressors, moderating and mediating factors, and stress reactions.

Objective:  This study was undertaken to investigate the relationship of periodontal disease in terms of clinical attachment level (CAL) to psychosocial stress, making reference to the major components of stress process.

Methods:  A cross‐sectional study of 1000 subjects aged 25–64 years in Hong Kong was conducted. Subjects were asked to complete a set of questionnaires measuring stressors including changes, significant life event and daily strains, stress reactions including physiological and affective responses, and coping and affective dispositions. CAL was assessed.

Results:  Individuals with high mean CAL values had higher scores on the job and financial strain scales than periodontally healthy individuals (P < 0.05), after adjusting for age, gender, cigarette smoking and systemic disease. Depression, anxiety trait, depression trait, problem‐focused coping, and emotion‐focused coping were also related to CAL. Logistic regression analysis indicated that all these factors were significant risk indicators for periodontal attachment loss, except problem‐focused coping, which reduced the odds of CAL. Individuals who were high emotion‐focused copers, low problem‐focused copers, trait anxious, or trait depressive had a higher odds of more severe CAL.

Conclusion:  Chronic job and financial strains, depression, inadequate coping, and maladaptive trait dispositions are significant risk indicators for periodontal attachment loss. Adequate coping and adaptive trait dispositions, evidenced as high problem‐focused coping and low anxiety/depression trait, may reduce the stress‐associated odds.
Multilevel analysis of group‐randomized trials with binary outcomes
Authors: Kim Hae‐Young , Preisser John S. , Gary Rozier R. , Valiyaparambil Jayasanker V.
Published: July 2006

Abstract – Objectives: Many dental studies have assessed the effectiveness of community‐ or group‐based interventions such as community water fluoridation. These cluster trials, of which group‐randomized trials (GRTs) are one type, have design and analysis considerations not found in studies with randomization of treatments to individuals (randomized controlled trials, RCTs). The purpose of this paper is to review analytic methods used for the analysis of binary outcomes from cluster trials and to illustrate these concepts and analytical methods using a school‐based GRT.

Methods: We examine characteristics of GRTs including intra‐class correlation (ICC), their most distinctive feature, and review analytical methods for GRTs including group‐level analysis, adjusted chi‐square test and multivariable analysis (mixed effect models and generalized estimating equations) for correlated binary data. We consider two‐ and three‐level modeling of data from a cross‐sectional cluster design. We apply the concepts reviewed using a GRT designed to determine the effect of incentives on response rates in a school‐based dental study. We compare the results of analyses using methods for correlated binary data with those from traditional methods that do not account for ICC.

Results: Application of traditional analytic methods to the dental GRT used as an example for this paper led to a substantial overstatement of the effectiveness of the intervention.

Conclusions: Ignoring the ICC among members of the same group in the analysis of public health intervention studies can lead to erroneous conclusions where groups are the unit of assignment. Special consideration is needed in the analysis of data from these cluster trials. Randomization of treatments to groups also should receive more consideration in the design of cluster trials in dental public health.
An analysis of oral and maxillofacial pathology found in adults over a 30‐year period
Authors: Jones A. V. , Franklin C. D.
Published: July 2006

Background:  The aim of this study was to determine the range of histologically diagnosed lesions in 44 000 oral and maxillofacial pathology specimens, from adults 17 years and older, submitted for diagnosis to our laboratory over a 30‐year period (1973–2002).

Materials:  All entries for specimens from the patients were retrieved and compiled into 12 diagnostic categories.

Results:  During the period, 44 007 specimens comprised a male‐to‐female ratio of 0.9:1. The diagnostic category with the largest number of specimens was mucosal pathology (36.0%) followed by odontogenic cysts (13.8%). Malignant tumours accounted for 5.4% of all specimens and benign tumours 4.6%.

Conclusion:  This survey showed that while the majority of diagnoses are benign, approximately one in 19 cases required major head and neck surgery for malignant disease.
Regression of gastroesophageal reflux disease symptoms using dietary supplementation with melatonin, vitamins and aminoacids: comparison with omeprazole
Authors: Pereira Ricardo de Souza
Published: July 2006

Abstract:  The prevalence of gastroesophageal reflux disease (GERD) is increasing. GERD is a chronic disease and its treatment is problematic. It may present with various symptoms including heartburn, regurgitation, dysphagia, coughing, hoarseness or chest pain. The aim of this study was to investigate if a dietary supplementation containing: melatonin, l‐tryptophan, vitamin B6, folic acid, vitamin B12, methionine and betaine would help patients with GERD, and to compare the preparation with 20 mg omeprazole. Melatonin has known inhibitory activities on gastric acid secretion and nitric oxide biosynthesis. Nitric oxide has an important role in the transient lower esophageal sphincter relaxation (TLESR), which is a major mechanism of reflux in patients with GERD. Others biocompounds of the formula display anti‐inflammatory and analgesic effects. A single blind randomized study was performed in which 176 patients underwent treatment using the supplement cited above (group A) and 175 received treatment of 20 mg omeprazole (group B). Symptoms were recorded in a diary and changes in severity of symptoms noted. All patients of the group A (100%) reported a complete regression of symptoms after 40 days of treatment. On the other hand, 115 subjects (65.7%) of the omeprazole reported regression of symptoms in the same period. There was statiscally significant difference between the groups (P < 0.05). This formulation promotes regression of GERD symptoms with no significant side effects.