bluuebunny/crossref_metadata_2025 huggingface dataset:
Our experience in eight cases with urinary hydatid disease: A series of 372 cases held in nine different clinics
Authors: YİLMAZ Y , KÖSEM M , CEYLAN K , KÖSEOGLU B , YALÇİNKAYA I , ARSLAN H , GÜNEŞ M , SÖYLEMEZ Ö
Published: September 2006

Objectives: Hydatid disease, a parasitic infestation caused by the larval stage of the cestode Echinococcus granulosus, is diagnosed commonly in the east and south‐east regions of Turkey. The aim of this study is to emphasize the relatively frequent occurrences of echinococcosis in our region, and to discuss therapeutic options and treatment results according to current literature.

Methods: A retrospective 10‐year review of nine different clinics’ records of the Research Hospital of the Medical School of Yüzüncü Yıl University revealed 372 hydatid disease cases that were localized in various organs and treated surgically (271 cases) or drained percutaneously (99 cases). Hydatid disease was diagnosed by ultrasonography (US) and computed tomography scans (CT) and confirmed histopathologically.

Results: The involved organ was lung in 203 cases (131 adults, 72 children), liver in 150, spleen in 9, brain in 2, kidneys in 7 cases and the retrovesical area in 1 case. The urogenital system is involved at a rate of 2.15%. Two hundred and seventy‐one cases were treated surgically and 99 percutaneously. Two cases with renal hydatid cyst refused the surgical procedure (one had a solitary kidney with hydatid cyst). Albendazole was administered to 192 patients; 93 patients had open surgical procedure and 99 patients underwent percutaneous procedure. Cysts were excised totally in the open surgical procedure; however, involved kidneys were removed totally (four cases) except one. Cystectomy and omentoplasty was performed in one case. Complications were as follows: in six cases, cystic material was spilled into the bronchial cavity during the dissection and a renal hydatid cyst ruptured and spilled retroperitoneally.

Conclusion: Hydatid disease is a serious health problem in Turkey. The mainly affected organs are liver and lung. It can be treated surgical or by percutaneous aspiration.
Complete response, as determined by prostate‐specific antigen level, to chlormadinone acetate withdrawal persisting longer than 2 years in patients with advanced prostate cancer: Two case reports
Authors: NOGUCHI KAZUMI , TERANISHI JUN‐ICHI , UEMURA HIROJI , FUJIKAWA NAOYA , SAITO KAZUO , MURAI TETSUO
Published: September 2006

Abstract  Antiandrogen withdrawal syndrome (AWS) is a well‐established phenomenon in prostate cancer. However, responses to AWS are usually of limited duration, and a complete response (CR) is extremely rare. We present two patients who exhibited a chemical CR for more than 2 years after the discontinuation of steroidal antiandrogen chlormadinone acetate use. Whether patients who respond to antiandrogen withdrawal include a group of patients with a better prognosis remains uncertain. However, considering that the usual survival period of patients with hormone‐resistant prostate cancer is approximately 12 months, both of the patients reported here, who are present in excellent physical condition, exhibiting an improved quality of life, and attending their hospital as outpatients, obviously acquired a prolonged survival because of AWS.
Surgical mesh used for an inguinal herniorrhaphy acting as a nidus for a bladder calculus
Authors: NGO TRU
Published: September 2006

Abstract  We describe an unusual case of surgical mesh used in laparoscopic inguinal herniorrhaphy acting as a nidus for a bladder calculus.
Protocol consisting of cisplatin, etoposide and irinotecan induced complete pathological remission of primary small cell carcinoma of the bladder
Authors: KAWAHARA TAKASHI , NISHIYAMA HIROYUKI , YAMAMOTO SHINGO , KAMOTO TOSHIYUKI , OGAWA OSAMU
Published: September 2006

Abstract  A 73‐year‐old man with primary small‐cell carcinoma of the bladder was treated by radical cystectomy with neoadjuvant chemotherapy. Pathological complete remission was achieved by combination chemotherapy composed of cisplatin, etoposide and irinotecan. The patient is free of disease 19 months after surgery.
General versus spinal anesthesia with different forms of sedation in patients undergoing radical retropubic prostatectomy: Results of a prospective, randomized study
Authors: SALONIA ANDREA , SUARDI NAZARENO , CRESCENTI ANTONELLA , COLOMBO RENZO , RIGATTI PATRIZIO , MONTORSI FRANCESCO
Published: September 2006

Aim: To assess the impact of spinal anesthesia (SpA) combined with three different forms of conscious sedation on intraoperative and postoperative outcome in patients undergoing radical retropubic prostatectomy (RRP) for organ confined prostate cancer (pCa).

Methods: A total of 121 consecutive patients with pCa undergoing RRP were randomized into four groups. They were randomized as follows: group 1 (general anesthesia: 34 patients), group 2 (lumbar 2 to lumbar 3 interspace SpA with diazepam as sedative agent: 28), group 3 (SpA with propofol: 30), and group 4 (SpA with midazolam: 29). Intraoperative and perioperative parameters were collected.

Results: The present study showed that muscle relaxation throughout RRP was not different in the four groups; bleeding was significantly (P = 0.04) lower with SpA, regardless of the form of sedation. Group 3 patients reported the best postoperative oxygen saturation percentage by pulse oximetry and sedation score (P = 0.02; d.f. = 3 and P < 0.0001; d.f. = 3, respectively), the shortest waiting time in the postoperative holding area (P < 0.001; d.f. = 3), the lowest pain on postoperative day 1 (P = 0.0004; d.f. = 3), and the highest frequency of first flatus passage (P = 0.0001; d.f. = 3). A higher number of group 4 patients were able to carry out unassisted ambulation (P < 0.0001; d.f. = 3).

Conclusions: Conscious sedation coupled with SpA is a safe, reliable and effective procedure for patients undergoing RRP. The use of propofol as sedative agent offers several advantages both over other types of conscious sedation and general anesthesia.
Joaquin Maria Albarran Y Dominguez: Microbiologist, histologist, and urologist–a lifetime from orphan in Cuba to Nobel nominee
Authors: CASEY ROWAN G , THORNHILL JOHN A
Published: September 2006

Abstract  Joaquin Albarran was an extraordinary late 19th century urologist. His early career was in the field of microbiology and histopathology in Paris at a time of great medical developments and innovations. His later contributions to urology included the Albarran lever, Albarrans sign, Albarran–Ormond syndrome and seminal works on testicular and renal tumors. He also wrote treatizes on the pathophysiology of acute urinary retention, nephritis and calculus ureteric obstruction. He died at the young age of 52 from the effects of tuberculosis and in this same year was nominated for the Nobel prize in medicine.
Emergence and composition of the traditional‐modern bicultural self of people in contemporary Taiwanese societies
Authors: Lu Luo , Yang Kuo‐Shu
Published: September 2006

In the present paper, a preliminary statement on the traditional‐modern bicultural self in contemporary Taiwan was proposed and our presentation was organized in four parts. First, a theoretical and conceptual analysis was attempted to describe the emergence and composition of the traditional‐modern bicultural self of the contemporary Taiwanese people. The cultural and social roots of such a bicultural self were explored, and its constituting elements delineated and their interrelations analyzed. Second, relevant empirical evidence pertaining to this particular model of the Chinese bicultural self was reviewed. Third, our present model was related and compared against various existing bicultural self models. Finally, directions and issues for future research on the Chinese bicultural self were discussed.
On How to Be Unpredictable
Authors: Mayr Ulrich , Bell Theodor
Published: September 2006

The voluntary task-switching paradigm requires subjects to select randomly between tasks and promises to provide a window into executive task selection independent of exogenous influences present in standard task-switching situations. We show here that the degree to which subjects perseverate on tasks across trials captures unique individual differences variance, but also that the switch rate is under strong stimulus-driven control: “Voluntary” switches are much more frequent when the stimulus changes than when it repeats. Most important, we show that individuals whose no-switch trials are selectively slowed exhibit less perseveration and stimulus-driven effects (and thus more voluntary selection) than individuals whose no-switch trials do not show this slowing. We suggest that selective slowing indicates a strategy of treating trials as discrete events—possibly through inhibition of the preceding task set. These results not only demonstrate massive nonvoluntary influences on voluntary selection that are largely untapped by standard task-switching measures, but also show how such influences can be counteracted through strategic adaptations.
CHINA'S EXCHANGE RATE APPRECIATION IN THE LIGHT OF THE EARLIER JAPANESE EXPERIENCE
Authors: McKinnon Ronald
Published: September 2006

Abstract.  For creditor countries such as China on the periphery of the dollar standard with current account surpluses, foreign mercantile pressure to appreciate their currencies and become more flexible is misplaced. Just the expectation of variable exchange appreciation seriously disrupts the natural tendency for wage growth to balance productivity growth and thus worsens the (incipient) deflation that China now faces. It could create a zero‐interest liquidity trap in financial markets that leaves the central bank helpless to combat future deflation arising out of actual currency appreciation, as with the earlier experience of Japan.
Onset and progression of primary torsion dystonia in sporadic and familial cases
Authors: Elia A. E. , Filippini G. , Bentivoglio A. R. , Fasano A. , Ialongo T. , Albanese A.
Published: September 2006

Four hundred and sixty records of patients with primary torsion dystonia (296 women and 164 men) were evaluated. The mean age at disease onset was 48.3 ± 17.7 years; 13 patients carried the DYT1 CAG deletion. The distribution of age at onset was represented by a bi‐modal curve, with a nadir at 21 year separating early onset from late onset cases. In 15.9% of cases there was a positive family history of dystonia. Cranial, cervical or lower limb onset was more common amongst women (M:F ratios were 1:2.7, 1:1.9, and 1:3); by contrast, onset in the upper limb was more common in men (M:F ratio 2.2:1). As expected, disease progression was more pronounced in cases with early onset; it was reckoned that onset at or above 32 years was associated with a negligible likelihood to progress to a generalized form. The mean age at onset of familial cases was 44.8 ± 11.2 years, significantly lower than the mean age at onset of sporadic cases (53.5 ± 13.4 years). Familial cases were characterized by more sites involved throughout disease course. Familial cases had a higher tendency to progress to a segmental or generalized form than sporadic cases.
Neurological complications of prolonged hunger strike
Authors: Başoğlu M. , Yetimalar Y. , Gürgör N. , Büyükçatalbaş S. , Kurt T. , Seçil Y. , Yeniocak A.
Published: September 2006

We investigated neurological findings in 41 prisoners (mean age: 28.6) who participated in a hunger strike between 2000 and 2002. All cases were evaluated using neuropsychological, neuroradiological, and electrophysiological methods. The total duration of fasting ranged from 130 to 324 days (mean 199 days). All cases had 200–600 mg/day thiamine orally for 60–294 days (mean 156) during the hunger strike, and had neurological findings consistent with Wernicke–Korsakoff syndrome. All 41 patients exhibited altered consciousness which lasted from 3 to 31 days. All patients also presented gaze‐evoked horizontal nystagmus and truncal ataxia. Paralysis of lateral rectus muscles was found in 14. Amnesia was apparent in all cases. Abnormal nerve conduction study parameters were not found in the patient group, but the amplitude of compound muscle action potential of the median and fibular nerves and sensory nerve action potential amplitude of the sural nerve were lower than the control group, and distal motor latency of the posterior tibial nerve was significantly prolonged as compared with the control group. The latency of visual evoked potential was prolonged in 22 cases. Somatosensory evoked potential (P37) was prolonged but not statistically significant. Our most significant finding was that the effect of hunger was more prominent on the central nervous system than on the neuromuscular system, despite the fact that all patients were taking thiamine. In our opinion, partial recovery of neurological, and neurocognitive signs in prolonged hunger could be a result of permanent neurological injury.
The prevalence of HFE C282Y gene mutation is increased in Spanish patients with porphyria cutanea tarda without hepatitis C virus infection
Authors: Toll A , Celis R , Ozalla MD , Bruguera M , Herrero C , Ercilla MG
Published: September 2006

Objectives  To investigate the role of C282Y and H63D mutations, and hepatitis C virus (HCV) infection in the pathogenesis of porphyria cutanea tarda (PCT).

Design  Prospective case‐control study.

Setting  A large clinical and research institute for the study and treatment of cutaneous diseases in Barcelona, Spain.

Patients  Ninety‐nine consecutive patients with PCT and one hundred and twenty‐six control patients (76 healthy subjects and 50 patients chronically infected with HCV), were recruited.

Main outcome measures  The frequency of the C282Y and H63D mutations in patients with PCT vs. controls and the relationship of these mutations with HCV infection, and iron status, as judged by serum iron, liver iron and ferritin levels.

Results  C282Y mutation was significantly increased in PCT patients. This mutation was more frequent among non‐HCV‐infected patients. Increased ferritin levels and hepatic iron overload were also observed in PCT patients with heterozygous C282Y state. H63D mutation was only significantly increased among PCT patients with chronic hepatitis C infection. No significant iron overload was observed in patients with H63D mutation.

Conclusions  This study confirms the high frequency of C282Y mutation in patients with PCT and its relationship with iron overload. The C282Y mutation has a relevant role in Spanish patients with PCT not associated with HCV chronic infection. On the other hand, the prevalence of the H63D mutation seems not to be increased in patients with PCT. The possibility of an association between HCV infection and H63D mutation in inducing PCT can be hypothesized.
The age‐related attenuation in long‐term potentiation is associated with microglial activation
Authors: Griffin Rebecca , Nally Rachel , Nolan Yvonne , McCartney Yvonne , Linden James , Lynch Marina A.
Published: September 2006

It is well established that inflammatory changes contribute to brain ageing, and an increased concentration of proinflammatory cytokine, interleukin‐1β (IL‐1β), has been reported in the aged brain associated with a deficit in long‐term potentiation (LTP) in rat hippocampus. The precise age at which changes are initiated is unclear. In this study, we investigate parallel changes in markers of inflammation and LTP in 3‐, 9‐ and 15‐month‐old rats. We report evidence of increased hippocampal concentrations of the proinflammatory cytokines IL‐1α, IL‐18 and interferon‐γ (IFNγ), which are accompanied by deficits in LTP in the older rats. We also show an increase in expression of markers of microglial activation, CD86, CD40 and intercellular adhesion molecules (ICAM). Associated with these changes, we observed a significant impairment of hippocampal LTP in the same rats. The importance of microglial activation in the attenuation of long‐term potentiation (LTP) was demonstrated using an inhibitor of microglial activation, minocycline; partial restoration of LTP in 15‐month‐old rats was observed following administration of minocycline. We propose that signs of neuroinflammation are observed in middle age and that these changes, which are characterized by microglial activation, may be triggered by IL‐18.
Bayesian Clustering of Farm Types Using the Mixtures Model
Authors: Tiffin Richard
Published: September 2006

A Bayesian method of classifying observations that are assumed to come from a number of distinct subpopulations is outlined. The method is illustrated with simulated data and applied to the classification of farms according to their level and variability of income. The resultant classification shows a greater diversity of technical charactersitics within farm types than is conventionally the case. The range of mean farm income between groups in the new classification is wider than that of the conventional method and the variability of income within groups is narrower. Results show that the highest income group in 2000 included large specialist dairy farmers and pig and poultry producers, whilst in 2001 it included large and small specialist dairy farms and large mixed dairy and arable farms. In both years the lowest income group is dominated by non‐milk producing livestock farms.
The War onTerroir: Geographical Indications as a Transatlantic Trade Conflict
Authors: Josling Tim
Published: September 2006

Terroir, the concept of an essential link between location of production and a specific quality attribute, is emerging as a contentious issue in trade negotiations and disputes. This issue is manifest through disputes and disagreements about appropriate protection of ‘geographical indications’ (GIs). This paper explores the differences in approach taken by the EU and the US towards GI protection, and illustrates the nature of the legal and economic arguments. The transatlantic dispute is spreading to other countries through the inclusion of GI protection in regional and bilateral trade pacts. It also has implications for the eventual conclusion of the WTO Doha Round negotiations, as the terroir issue arises in both the agricultural and the Trade‐Related Intellectual Property (TRIPS) agendas, once again pitting the US and EU as protagonists. But there are signs of change in these positions as the GI system in the EU comes under review and producers in the US reconsider the possible advantages of location‐based identifiers. These issues are important in a number of food sectors, and are likely to be persistent. They deserve more attention from practising applied economists than they have yet received.
Reactions of aminoarylazopyrazoles with active methylene compounds. Part 1: Synthesis of 7‐amino‐3‐arylazo‐6‐cyano‐2‐methylpyrazolo[5,1‐c][1,2,4]triazines
Authors: Karcı Fikret , Şener İzzet , Demirçalı Aykut , Burukoğlu Nesrin
Published: September 2006

In this study, 2‐arylhydrazone‐3‐ketiminobutyronitriles were synthesised and reacted with hydrazine hydrate to afford 5‐amino‐4‐arylazo‐3‐methyl‐1H‐pyrazoles. These compounds were then diazotised and coupled with malononitrile to give pyrazolylazomalononitriles. Thirteen novel pyrazolo[5,1‐c][1,2,4]triazine dyes were synthesised by heating pyrazolylazomalononitriles in glacial acetic acid and characterised by elemental analysis and spectral methods. The effect of varying pH and solvent upon the absorption ability of the dyes substituted with electron‐withdrawing and electron‐donating groups at their o‐, m‐ and p‐position was examined in detail.
Effect of Fenton's reagent on the degradability of CI Reactive Yellow 15
Authors: Eren Zeynep , Acar Filiz Nuran
Published: September 2006

As an advanced oxidation method, Fenton's reagent has an advantage that it combines both oxidation and coagulation techniques. The aim of this study was to efficiently operate Fenton's reagent oxidation to degrade a reactive dye, CI Reactive Yellow 15, which is non‐biodegradable and has high chemical oxygen demand. In addition, performance of the Fenton oxidation process for dye solution was determined by measuring the chemical oxygen demand and colour removal. The influence of the main operating parameters, iron sulphate and hydrogen peroxide concentration, pH, temperature and dye concentration have been studied, in a batch‐type operation. The results obtained show that the best pH value for decolorisation was pH 3, with an average decolorisation of 98.7% and average removal of chemical oxygen demand ca. 93.3% at 15 °C for a 0.065 molar ratio of Fenton's reagent. An increase in temperature resulted in higher removal rates.
Sir William Henry Perkin: a review of his life, work and legacy
Authors: Holme Ian
Published: September 2006

One hundred and fifty years ago the world of coloration changed forever with William Henry Perkin's discovery of the first synthetic dye derived from coal tar. The life, work and legacy of Sir William Henry Perkin are reviewed in the light of his early chemical education, his training in coal tar chemistry with Hofmann, and his discovery, patenting and manufacture of mauveine. This was the first synthetic dyestuff to be manufactured in a purpose‐built industrial chemical plant anywhere in the world.
Pentylenetetrazol‐Induced Seizures Decrease γ‐Aminobutyric Acid‐Mediated Recurrent Inhibition and Enhance Adenosine‐Mediated Depression
Authors: Psarropoulou C. , Matsokis N. , Angelatou F. , Kostopoulos G.
Published: September 2006

Summary: To elucidate the consequences of convulsions, we examined biochemically and electrophysiologically the brains of mice that had sustained two complete tonicclonic convulsions after administration of pentylenetetrazol (PTZ 50 mg/kg intraperitoneally, i.p.), 48 and 24 h before decapitation. Control mice were injected with saline. Input/output curves of the extracellular synaptic responses in the CAI area of hippocampal slices showed that PTZ‐induced seizures do not establish the persistent change in hippocampal excitability itself that can be detected in vitro. However, use of the paired‐pulse stimulation paradigm showed that γ‐aminobutyric acid, (GABA)‐mediated recurrent inhibition was significantly weaker (by 19–25%) in the CA1 area of slices from PTZtreated mice (PTZ slices) as compared with slices from control mice (control slices). The density of GABA, receptors (high‐affinity component) was also lower in hippocampus (by 19%) and cortex (by 14%) of PTZ‐treated mice. A GABA‐related disinhibitory mechanism underlying PTZ seizures may thus persist for 1 day after the seizure, predisposing the brain to subsequent seizures. On the other hand, the depressant effect of a single dose of adenosine 10 μM on the CA1 synaptic response was stronger (by 35% on population spikes) and longer lasting in PTZ slices as compared with controls. This could be attributed to significantly higher adenosine A1 receptor density in hippocampus (Bmax of [3H]CHA was higher by 34%) as well as cortex and cerebellum of these animals. The phenomenon may reflect an adenosine A1‐mediated adaptive mechanism that offers protection from subsequent seizures.
Determinants of Mortality in Status Epilepticus
Authors: Towne Alan R. , Pellock John M. , Ko Daijin , DeLorenzo Robert J.
Published: September 2006

Summary: Using univariate and multivariate regression analysis, we studied seizure duration, seizure type, age, etiologies, other clinical features, and mortality among 253 adults with status epilepticus (SE) admitted to the Medical College of Virginia. Cerebral vascular disease and discontinuation of antiepileptic drugs (AEDs) were the most prominent causes of SE, each accounting for ∼22% of all patients in the series. The other principle etiologies were alcohol withdrawal, idiopathic, anoxia, metabolic disorders, hemorrhage, infection, tumor, drug overdose, and trauma. When the patients were divided into two groups, the group with SE lasting < 1 h had a lower mortality as compared with seizure duration ≥ 1 h. Low mortality rates were noted in alcohol and AED discontinuation etiologies. Anoxia and increasing age were significantly correlated with higher mortality. The mortality rates of partial and generalized SE were not significantly different. Race and sex did not affect mortality significantly. Our findings represent the first multivariate analysis of predictive indicators of mortality in SE and demonstrate that specific factors influence mortality rate in SE.
Reevaluation of Surgical Failures and the Role of Reoperation in 39 Patients with Frontal Lobe Epilepsy
Authors: Salanova V. , Quesney L. F. , Rasmussen T. , Andermann F. , Olivier A.
Published: September 2006

Summary: Between 1929 and 1980, 284 patients with refractory nontumoral frontal lobe epilepsy (FLE) underwent operation at the Montreal Neurological Institute (MNI). We studied 39 patients (14%) who required reoperation. Mean age at the time of first operation was 18 years and at reoperation was 22 years. Clinical manifestations were similar to those of patients with “a pure culture of frontal lobe epilepsy” as reported by Rasmussen in 1983. At the time of first operation, large epileptogenic zones were noted in most patients. Resection was confined to the frontal lobe. Continuing seizure activity was due to residual areas of epileptogenesis, and reoperation with more extensive resection of cortex increased the number of seizure‐free patients. Twenty‐six patients underwent further frontal resection, and in 13 surgical removal was extended to the temporal lobe. Residual electrocorticographic (ECoG) spiking was documented in 15 of 23 (65%) of the reoperated patients. Thirty‐five patients were followed for periods ranging from 4 to 46 years. One fifth became seizure‐free, and 31% had significant seizure reduction. Thus, half of these patients had a good result. Patients with residual postexcision ECoG spiking had poor outcomes and evidence of large epileptogenic zones. None of the patients who underwent frontotemporal resections became seizure‐free. Reoperation should be considered if initial resection does not lead to a satisfactory result and may convert an initial failure into a good surgical result.
Perceptions of Control in Adults with Epilepsy
Authors: Gehlert Sarah
Published: September 2006

Summary: That psychosocial problems are extant in epilepsy is evidenced by a suicide rate among epileptic persons five times that of the general population and an unemployment rate estimated to be more than twice that of the population as a whole. External perceptions of control secondary to repeated episodes of seizure activity that generalize to the social sphere have been implicated as causes of these problems. The hypothesis that individuals who continue to have seizures become more and more external in perceptions of control was tested by a survey mailed to a sample of individuals with epilepsy in a metropolitan area of the Midwest. Dependent variables were scores on instruments measuring locus of control and attributional style. The independent variable was a measure of seizure control based on present age, age at onset, and length of time since last seizure. Gender, socioeconomic status, and certain parenting characteristics were included as control variables, as they are also known to affect perceptions of control. Analysis by multiple regression techniques supported the study's hypothesis when perceptions of control was conceptualized as learned helplessness for bad, but not for good, events. The hypothesis was not confirmed when perceptions of control was conceptualized as either general or health locus of control.
Epilepsy and Pregnancy: A Prospective Study of Seizure Control in Relation to Free and Total Plasma Concentrations of Carbamazepine and Phenytoin
Authors: Tomson Torbjörn , Lindbom Ulla , Ekqvist Britta , Sundqvist Anders
Published: September 2006

Summary: Seizure control and plasma concentrations of antiepileptic drugs (AEDs) were determined in a prospective, population‐based study of 93 pregnancies (cases) of 70 patients with epilepsy. Seventy‐seven cases were treated with monotherapy, which in 70 cases consisted of carbamazepine (CBZ) or phenytoin (PHT). Dosage was kept constant unless poor seizure control prompted an increase. Plasma concentrations were determined at monthly intervals throughout pregnancy and compared with baseline levels obtained at least 10 weeks postpartum. Both free and total CBZ and PHT concentrations were analyzed. Seizure frequency during pregnancy for the group as a whole was not different as compared with the 9 pregestational months and was unaltered or im proved in 85% of cases. Total CBZ concentration was slightly lower during the third trimester as compared with baseline, whereas free concentration was unchanged. In contrast, PHT levels decreased steadily as pregnancy progressed. Total plasma concentration was 39% of base‐line during the third trimester, whereas free PHT concentration decreased far less, being 82% of baseline level during the third trimester. No clear‐cut relation could be demonstrated between seizure control and plasma concentrations, which may be explained by the limited changes in free AED concentrations and the small number of cases with an increased seizure frequency. Our results indicate that total plasma concentrations may be misleading and that monitoring of free concentrations, in particular of PHT concentrations, may be advantageous during pregnancy.
Disposition of Carbamazepine and Phenytoin in Pregnancy
Authors: Tomson Torbjörn , Lindbom Ulla , Ekqvist Britta , Sundqvist Anders
Published: September 2006

Summary: Free and total plasma concentrations of phenytoin (PHT) and carbamazepine (CBZ) and its active metabolite carbamazepine‐10,11‐epoxide (CBZ‐E) were determined in a prospective study of 86 pregnant epileptic women. The pharmacokinetics of PHT and CBZ during the three trimesters were compared with kinetics at least 10 weeks postpartum. Plasma clearance and unbound CBZ clearance were slightly decreased during the last trimester. Total and free plasma CBZ‐E concentrations did not change significantly during pregnancy. Plasma PHT clearance, on the other hand, increased from the first trimester. A less pronounced increase was observed for clearance of unbound PHT; the increase was statistically significant only during the third trimester.
Effect of Phenytoin on Semen
Authors: Taneja Neelam , Kucheria K. , Jain S. , Maheshwari M. C.
Published: September 2006

Summary: Male patients receiving antiepileptic drugs (AEDs) have often complained of hyposexuality. Few studies have been done on semen analysis, which is relevant for assessment of potential and possible reproductive outcome in such cases. We evaluated the effect of epilepsy itself and/or phenytoin (PHT) on the male reproductive system. Fifty‐five patients with epilepsy (42 with PHT and 13 untreated) and 28 healthy normal controls were studied by semen analysis. Serum samples from 21 of the 55 patients were also analyzed for testosterone, luteinizing hormone (LH), and follicle‐stimulating hormone. Results showed lower volume of seminal fluid, spermatozoa concentration, and total sperm count in untreated and PHT‐treated patients as compared with controls, although no difference was evident between the patient groups. Morphologically abnormal sperm were more increased in untreated patients than in PHT treated and control subjects. Hormonal analysis showed lower levels of testosterone in 9 patients. LH levels were increased in one third of the patients. Our results suggests an effect of seizures on the male reproductive system, and PHT may have a slight additive (if any) influence.
Systemic Lupus Erythematosus Associated with Use of Valproate
Authors: Asconapé Jorge J. , Manning Kenneth R. , Lancman Marcelo E.
Published: September 2006

Summary: A 30‐year‐old man with long‐standing localization‐related epilepsy and mental retardation had seizures that were partially controlled with valproate (VPA) 500 mg four times daily. Routine examination showed severe thrombocytopenia with mild leukopenia and chronic lowgrade hemolytic anemia. Pertinent laboratory results included positive ANA, rheumatoid factor, anti‐NIA, circulating immune complexes, and antihistone antibody. The patient was treated with high dosage prednisone with partial improvement, but continued to have exacerbations at lower dosages. Fourteen months later, VPA was discontinued, and rapid improvement ensued. Prednisone was subsequently discontinued, and the patient has now maintained normal platelet counts for 18 months.
Effects of Phenytoin on Cognitive‐Motor Performance in Children as a Function of Drug Concentration, Seizure Type, and Time of Medication
Authors: Aman Michael G. , Werry John S. , Paxton James W. , Turbott Sarah H.
Published: September 2006

Summary: Fifty children with well‐controlled seizures who were receiving phenytoin (PHT) monotherapy were tested three times at weekly intervals on a cognitivemotor test battery. The first assessment served as a practice session, and PHT was given either before or withheld until after testing to create peak and trough concentrations, respectively, in the second and third sessions. On average, PHT levels as measured in saliva were in the low therapeutic range. The experimental condition (PHT before or after test sessions) was randomized and balanced across subjects, and assessments were made with examiners blind to diagnosis and timing of PHT ingestion. A variety of statistical models was used to analyze for the effect of age, diagnosis (partial vs. generalized epilepsy), PHT order, PHT concentration (as measured in saliva), and trough/peak concentration effects. Greater age was consistently associated with better performance, but diagnosis, PHT concentration levels, and transition from trough to peak concentration days had few discernible effects on psychomotor performance. Thus, fluctuations in PHT, of the order of 50%, appear to have no or immeasurably small effects in children with well‐controlled seizures receiving monotherapy in low therapeutic dosages.
Paroxysmal Motor Disorders of Sleep: The Clinical Spectrum and Differentiation from Epilepsy
Authors: Derry Christopher P. , Duncan John S. , Berkovic Samuel F.
Published: September 2006

Summary: The diagnosis of paroxysmal events in sleep represents a significant challenge for the clinician, with the distinction of nocturnal epilepsy from nonepileptic sleep disorders often the primary concern. Diagnostic error or uncertainty is not uncommon in this situation, particularly with respect to nocturnal frontal lobe epilepsy (NFLE), which has a variable and often unusual presentation. Such errors can be minimized if the range of nonepileptic disorders with motor activity in sleep is fully appreciated. Here we review these disorders, before discussing the important clinical and electrographic features that allow their accurate differentiation from seizures. Particular emphasis is placed on the differentiation of nocturnal frontal lobe epilepsy from non–rapid eye movement (NREM) arousal disorders and other parasomnias. The value of recording episodes with video EEG polysomnography is discussed.
Autosomal Dominant Early‐onset Cortical Myoclonus, Photic‐induced Myoclonus, and Epilepsy in a Large Pedigree
Authors: Gardella Elena , Tinuper Paolo , Marini Carla , Guerrini Renzo , Parrini Elena , Bisulli Francesca , Liguori Rocco , Montagna Pasquale , Lugaresi Elio
Published: September 2006

Summary:  Purpose: Cortical tremor, a form of rhythmic cortical myoclonus (rhythmic CM), and epilepsy have been described in families with autosomal dominant inheritance. Linkage analyses revealed two putative loci on chromosome 2p and 8q. Clinical photosensitivity was not a prominent feature in such families. We describe a large Italian family with rhythmic CM, photosensitivity, and epilepsy.

Methods: Twenty‐three individuals of a five‐generation family were studied. Linkage analyses for the loci on chromosome 2p11.1 and 8q23.3 were performed.

Results: Of the 23 studied family members, 16 were affected. Rhythmic CM of childhood onset was present in all 16 individuals (onset ranging from 3 to 12 years), was associated with photic‐induced myoclonic jerks in seven, and with epileptic seizures in six (onset ranging from 23 to 34 years). Five children of the V generation manifested also episodes of arousal with generalized tremor in early infancy (“tremulous arousals”). Jerk‐locked back‐averaging of rhythmic CM of six affected individuals, documented a premyoclonic EEG correlate. C‐reflex at rest was present in two affected adults. Linkage analyses excluded mapping to the 2p11.1 and 8q23.3 loci.

Conclusions: Clinical variability and severity of the phenotypes in this family are in line with those of previously described pedigrees with autosomal dominant cortical myoclonus and epilepsy. In this family, a progression of symptoms was found: rhythmic CM and tremulous arousals occurred in childhood, whereas visually induced manifestations and epileptic seizures occurred during adolescence–adulthood. Exclusion of linkage to the two known loci is consistent with genetic heterogeneity of such familial clustering of symptoms.
Increased GABAA‐Receptor α1‐Subunit Expression in Hippocampal Dentate Gyrus after Early‐life Status Epilepticus
Authors: Raol YogendraSinh H. , Zhang Guojun , Lund Ingrid V. , Porter Brenda E. , Maronski Margaret A. , Brooks‐Kayal Amy R.
Published: September 2006

Summary:  Purpose: Previous studies in neonatal (postnatal day 10) and adult rats suggest that status epilepticus (SE) induces changes in the α1 subunit of the GABAA receptor (GABRA1) in dentate granule neurons (DGNs) that are age dependent and vary inversely with the likelihood of epilepsy development. In the present study, we examined GABRA1 expression after SE at postnatal day 20 (P20), an intermediate age when only a subset of SE‐exposed animals develop epilepsy.

Methods: SE was induced with lithium‐pilocarpine or kainate at P20. Animals were video‐EEG monitored after SE to determine the presence or absence of spontaneous seizures. GABRA1 mRNA and protein levels were determined 7 days or 3 months later in SE‐exposed and control animals by using a combination of aRNA amplification, Western blotting, and immunohistochemistry techniques.

Results: GABRA1 mRNA levels in DGNs of SE‐exposed rats that did not become epileptic were higher than those in control rats, but were not different from DGNs in epileptic SE‐exposed rats. GABRA1 protein levels in dentate gyrus were significantly increased in both epileptic and nonepileptic SE‐exposed rats compared with controls. GABRA1 mRNA changes were region specific and did not occur in CA1 or CA3 areas of hippocampus. GABRA1 alterations were present by 1 week after P20 SE and were similar whether pilocarpine or kainate was used to induced SE.

Conclusions: P20 SE results in persistent increases in GABRA1 levels selectively in dentate gyrus. These changes preceded the onset of epilepsy, were not model specific, and occurred in both epileptic and nonepileptic animals.
Heterogeneity at the JME 6p11–12 Locus: Absence of Mutations in the EFHC1 Gene in Linked Dutch Families
Authors: Pinto Dalila , Louwaars Sandrien , Westland Birgit , Volkers Linda , De Haan Gerrit‐Jan , Trenité Dorothée G.A. Kasteleijn‐Nolst , Lindhout Dick , Koeleman Bobby P.C.
Published: September 2006

Summary:  Purpose: The EFHC1 gene, encoding a protein with a Ca2+‐sensing EF‐hand motif, is localized at 6p12 and was recently reported as mutated in six Mexican juvenile myoclonic epilepsy (JME) families linked to this region. We had previously confirmed linkage between JME and 6p11‐12 in 18 Dutch families, and shown exclusionary lod scores at 6p21.3. We therefore evaluated the relevance of EFHC1 in our set of 6p11‐12–linked families.

Methods: We screened all coding and regulatory regions of EFHC1 by direct sequencing, and the detected variants were tested in a case–control association study.

Results: We found none of the five mutations previously reported in the Mexican families, but identified nine variants, three of which are novel: 5′ upstream region (c.‐146_147delGC), nonsynonymous (R159W, R182H, M448T, I619L), intronic (IVS3 + 10A>G, IVS8 + 175_176delTT, IVS10 + 59C>T), and 3′ UTR (c.+121C>A). These variants did not cosegregate with JME and did not account for the observed linkage at the 6p11‐12 locus. Furthermore, no significant association was detected between JME and these variants in 112 unrelated patients and 180 controls. Finally, none of the mutations reported in Mexican families was found in 100 unrelated patients.

Conclusions: We found no evidence that EFHC1 is a major genetic risk factor for JME susceptibility in Dutch patients. The EFHC1 variants reported in Mexican families may be mendelian variants specific for those families, suggesting that for Dutch patients and possibly many other populations, the main disease variant at the 6p11‐12 is yet to be identified.
Exploration of the Genetic Architecture of Idiopathic Generalized Epilepsies
Authors: Hempelmann Anne , Taylor Kirsten P. , Heils Armin , Lorenz Susanne , Prud'Homme Jean‐Francois , Nabbout Rima , Dulac Olivier , Rudolf Gabrielle , Zara Federico , Bianchi Amedeo , Robinson Robert , Gardiner R. Mark , Covanis Athanasios , Lindhout Dick , Stephani Ulrich , Elger Christian E. , Weber Yvonne G. , Lerche Holger , Nürnberg Peter , Kron Katherine L. , Scheffer Ingrid E. , Mulley John C. , Berkovic Samuel F. , Sander Thomas
Published: September 2006

Summary:  Purpose: Idiopathic generalized epilepsy (IGE) accounts for ∼20% of all epilepsies and affects about 0.2% of the general population. The etiology of IGE is genetically determined, but the complex pattern of inheritance suggests an involvement of a large number of susceptibility genes. The objective of the present study was to explore the genetic architecture of common IGE syndromes and to dissect out susceptibility loci predisposing to absence or myoclonic seizures.

Methods: Genome‐wide linkage scans were performed in 126 IGE‐multiplex families of European origin ascertained through a proband with idiopathic absence epilepsy or juvenile myoclonic epilepsy. Each family had at least two siblings affected by IGE. To search for seizure type–related susceptibility loci, linkage analyses were carried out in family subgroups segregating either typical absence seizures or myoclonic and generalized tonic–clonic seizures on awakening.

Results: Nonparametric linkage scans revealed evidence for complex and heterogeneous genetic architectures involving linkage signals at 5q34, 6p12, 11q13, 13q22‐q31, and 19q13. The signal patterns differed in their composition, depending on the predominant seizure type in the families.

Conclusions: Our results are consistent with heterogeneous configurations of susceptibility loci associated with different IGE subtypes. Genetic determinants on 11q13 and 13q22‐q31 seem to predispose preferentially to absence seizures, whereas loci on 5q34, 6p12, and 19q13 confer susceptibility to myoclonic and generalized tonic–clonic seizures on awakening.
Endogenous Fractal Dynamics at Alpine Treeline Ecotones
Authors: Zeng Yu , Malanson George P.
Published: September 2006

Many of the hypotheses proposed to explain ecotones are based on an individualistic paradigm and are essentially static. While they include local feedbacks, they ignore the interactions between pattern and process across scales. These feedbacks in ecotones are nonlinear in nature and complicate the relations of pattern and process in vegetation, which, combined with observed fractal patterns, suggests a complexity science approach to investigate ecotone dynamics. A cellular automaton of alpine treeline, including nonlinear, local, positive, and negative feedbacks in tree establishment and mortality, as reported in field studies, is used as a model system. Fourier analysis of simulated alpine treelines shows fractal patterns across the treeline landscapes, which are created by patch development. The temporal evolution of the spatial pattern is also fractal. Landscape scale linear correlations between spatial pattern and the rate of advance of trees into tundra arise from localized nonlinear interactions. A tree‐patch‐landscape scale explanation of pattern–process interaction is proposed in which the endogenous feedbacks determine the spatial and temporal fractal properties of the ecotone. The simulated treeline advance exhibits self‐organized complexity and may indicate a potential strategy for monitoring change.
Rapid Detection and Successful Treatment of Esophageal Perforation After Radiofrequency Ablation of Atrial Fibrillation: Lessons from Five Cases
Authors: DAGRES NIKOLAOS , KOTTKAMP HANS , PIORKOWSKI CHRISTOPHER , DOLL NICOLAS , MOHR FRIEDRICH , HORLITZ MARC , KREMASTINOS DIMITRIOS TH. , HINDRICKS GERHARD
Published: September 2006

Introduction: The aim of the study was to identify criteria for rapid recognition and successful treatment of esophageal perforation after radiofrequency ablation for atrial fibrillation (AF).

Methods and Results: Esophageal perforation occurred in five patients after intraoperative (n = 4) or percutaneous (n = 1) AF ablation. Patients presented with high fever (n = 3) or severe chest/epigastric pain (n = 2) 8–28 days after ablation. WBC count was elevated at presentation in all patients (15,460 ± 2,910/μL), CRP showed a delayed rise. Thoracic CT detected free air in all. Neurologic complications occurred in three cases (60%) with a delay of 5–40 hours after first symptoms. Only one (20%) developed neurologic complications within the first 24 hours. Two patients (40%) died before surgery could be performed. In both, time from symptom onset to diagnosis was significant (24 and 36 hours). Three patients (60%) underwent esophageal resection and survived. In two of them, treatment was rapid with time from symptoms to surgery of 24 hours; they had favorable outcome. In the third surviving patient, surgery was late (5 days after first symptoms); permanent neurologic residues remained.

Conclusion: The leading symptom of esophageal perforation is high fever or severe chest/epigastric pain. Fever is not necessarily present. Leukocytosis is the earliest and most sensitive laboratory marker, thoracic CT the most valuable diagnostic examination. The dramatic neurologic complications occur with a delay of at least a few hours after first symptoms. Immediate surgery may prevent neurologic complications and could possibly result in a high survival rate without residues. Delay of treatment seems to have devastating results.
Contemporary Methods of Labeling Dental Prostheses—A Review of the Literature
Authors: Richmond Raymond , Pretty Iain A.
Published: September 2006

ABSTRACT: Forensic identification (ID) based on an assessment of the dentition is common place. However, despite an increase in the oral health of Western populations, there are still many millions of individuals who are edentulous and whom have been treated with completed dentures. In the United Kingdom alone over 300,000 patients are rendered edentulous each year. In order to facilitate the ID of such individuals a number of forensic and governmental organizations have recommended that dentures be labeled. A number of labeling systems exist which can be broadly separated into inclusion systems, marking systems, and novel methods. Each of the commonly described systems are demonstrated with an assessment of their strengths and weaknesses. It is recommended that an inclusion denture marker, preferably metallic, should be used in order to withstand the most common postmortem assaults.
Distribution of D4S1654, D4S3255, and GATA148G10 Alleles in a Chinese Population Sample
Authors: Wang Jing , Long Bing , Liu Zhiyong , Chen Guodi , Yu Lin , Ma Feng Zhen , Song Yanhua , Zhang Lin
Published: September 2006

POPULATION: Chinese.
Allele Frequency Data for Nine STRs Polymorphism in a Gurkha Population of Malaysia
Authors: Tuladhar Bhinu Shova , Haslindawaty Nur , Nada B. , Panneerchelvam S. , Norazmi M. N.
Published: September 2006

POPULATION: Random Gurkha Population, Rawang, Malaysia.