bluuebunny/crossref_metadata_2025 huggingface dataset:
Emblemas portátiles: el empleo de divisas metálicas como adorno de sombrero y vestimenta, y su función en el origen del género emblemático
Authors: García Arranz José Julio
Published: February 2016

ABSTRACT: The medieval custom of wearing figurative insignias on hats and caps became widespread during the 14th century when the uses and functions of these elements diversified and personal devises or badges became fashionable. As such, at the end of the Middle Ages and at the beginning of the 16th century, these portable “emblems” became commonly used objects, with their application on clothing becoming more and more frequent. In the present work, we will address the existing reciprocal relationship between printed emblem collections and appliqués for hats and clothing, in the sense that both creations date back decades to the definitive decline of metallic insignias. KEYWORDS: Medieval insígnia, emblem, badge, devise, enseigne, emblem prototypes  RESUMEN: La costumbre medieval de portar insignias figuradas en sombreros y gorras se generaliza durante el s. XIV, momento en que los usos y funciones de estos elementos se diversifican, y se incorporan a la moda de las devises o badges personales. De este modo, a fines de la Edad Media e inicios del quinientos, estos «emblemas» portátiles devienen objeto de uso común, siendo cada vez más frecuente su aplicación a la indumentaria del momento. En el presente trabajo nos aproximaremos a la recíproca relación existente entre las colecciones de emblemas impresos y los apliques parlantes de sombreros y vestimentas, en el sentido de que ambas creaciones se retroalimentaron durante algunas décadas, hasta el declive definitivo de las insignias metálicas. PALABRAS CLAVES: Insignia medieval, badge, devise, enseigne, emblema, protoemblemática.
Emblemática, mnemotecnia y el arte de narrar: El episodio de Everardo en El peregrino en su patria de Lope de Vega
Authors: Mesa Higuera Claudia
Published: February 2016

ABSTRACT: This essay examines an aspect of Lope de Vega’s iconographic program in The Pilgrim, or Stranger in His Own Country by focusing on the interpolated tale of Everardo, a Christian knight who has been confined to a prison cell that is painted with «hieroglyphs and verses». The episode combines rhetorical and dialectical aspects of memory and establishes a connection between artificial memory systems, emblems, secular meditational practices, and story telling. I propose that Everardo’s tale displays a mnemonic intentionality that connects it with artificial systems of memory developed in classical antiquity and later used as prototypes during the early modern period. The episode not only emphasizes the importance of images as a stimulus for memory but also generates a sequential dual narrative in which the mental processes associated with rhetorical and dialectical memory coincide around specific images. KEYWORDS: Mnemotechnics, Art of Narration, Everardo, El Peregrino en Patria, Lope de Vega.   RESUMEN: Este ensayo examina un aspecto del programa iconográfico del Peregrino en su patria de Lope de Vega al enfocarse en el relato intercalado de Everardo, un caballero preso en una celda cuyas paredes se encuentran dibujadas con «hieroglíficas y versos». El episodio combina aspectos retóricos y dialécticos de la memoria y propicia la conexión entre sistemas de memoria artificial, emblemas, prácticas meditativas de corte secular y estrategias narrativas. Propongo que el relato de Everardo puede entenderse a la luz de cierta intencionalidad mnemónica, que lo vincula con los sistemas de memoria artificial desarrollados en la antigüedad clásica y posteriormente usados como prototipos durante la temprana modernidad. Este episodio no sólo destaca la importancia de la imagen como estímulo para la memoria sino que también genera una narración secuencial a dos voces donde los procesos mentales asociados con la memoria retórica y la dialéctica encuentran resolución. PALABRAS CLAVES: mnemotecnia, arte de narrar, Everardo, El Peregrino en Patria, Lope de Vega.
Fuego de artificio
Authors: Editorial Equipo
Published: February 2016

Artículo Editorial.Gracias a los esfuerzos del equipo de IMAGO, la revista ha llegado a ser indexada últimamente por Erihplus y Latindex, mientras que Thomson Reuters nos ha comunicado que están valorando la posible indexación tras haber incluido IMAGO entre las revistas emergentes.
Employees’ Vocational Training and Corporate Social Responsibility (CSR):beyond “Primary Responsibilities”
Authors: Lê Thi Thu Thao , De Nanteuil Matthieu
Published: February 2016

This article aims at looking at ethical issues in vocational training. It widely explores the specific role of vocational training among the set of “responsibilities” that a company could have, not only towards it stakeholders, but also towards its own workforce. Underlying the multiple unfair sources of employees’ vocational training- the unequal access to training is one of them - we try to examine the possible combinations between CSR and this human resource practice. Through a critical outlook on CSR, we analyze different levels of CSR and insist on “ethical responsibilities” – a form of responsibility that aims at recognizing the employees as ethical subjects.
The Michoacanazo: A Case-Study of Wrongdoing in the Mexican Federal Judiciary
Authors: Gabriel Ferreyra
Published: February 2016

The Michoacanazo was a federal criminal trial in Mexico prosecuted by the Attorney General’s Office against local and state public officials from the state of Michoacán who were indicted for having ties with the local drug cartel formally known as “La Familia Michoacana.” With the indictment, more than 30 public servants were arrested and sent to prison in a roundup carried out by the federal police in May 2009. Within a two-year period, all of those arrested were eventually released. This case had strong legal and political implications nationwide because it pitted the state of Michoacán against the federal government, as well as President Felipe Calderon’s administration against the Mexican Federal Judiciary. The Michoacanazo provides a glimpse into the inner workings of the Mexican federal judiciary when powerful interests collide, and corruption intermingles with politics, a drug cartel, and the complexities of handling drug-related trials.
Azimuthal diffusion of the large-scale-circulation plane, and absence of significant non-Boussinesq effects, in turbulent convection near the ultimate-state transition
Authors: He Xiaozhou , Bodenschatz Eberhard , Ahlers Guenter
Published: February 2016

We present measurements of the orientation ${\it\theta}_{0}$ and temperature amplitude ${\it\delta}$ of the large-scale circulation in a cylindrical sample of turbulent Rayleigh–Bénard convection (RBC) with aspect ratio ${\it\Gamma}\equiv D/L=1.00$ ($D$ and $L$ are the diameter and height respectively) and for the Prandtl number $Pr\simeq 0.8$. The results for ${\it\theta}_{0}$ revealed a preferred orientation with up-flow in the west, consistent with a broken azimuthal invariance due to the Earth’s Coriolis force (see Brown & Ahlers (Phys. Fluids, vol. 18, 2006, 125108)). They yielded the azimuthal diffusivity $D_{{\it\theta}}$ and a corresponding Reynolds number $Re_{{\it\theta}}$ for Rayleigh numbers over the range $2\times 10^{12}\lesssim Ra\lesssim 1.5\times 10^{14}$. In the classical state ($Ra\lesssim 2\times 10^{13}$) the results were consistent with the measurements by Brown & Ahlers (J. Fluid Mech., vol. 568, 2006, pp. 351–386) for $Ra\lesssim 10^{11}$ and $Pr=4.38$, which gave $Re_{{\it\theta}}\propto Ra^{0.28}$, and with the Prandtl-number dependence $Re_{{\it\theta}}\propto Pr^{-1.2}$ as found previously also for the velocity-fluctuation Reynolds number $Re_{V}$ (He et al., New J. Phys., vol. 17, 2015, 063028). At larger $Ra$ the data for $Re_{{\it\theta}}(Ra)$ revealed a transition to a new state, known as the ‘ultimate’ state, which was first seen in the Nusselt number $Nu(Ra)$ and in $Re_{V}(Ra)$ at $Ra_{1}^{\ast }\simeq 2\times 10^{13}$ and $Ra_{2}^{\ast }\simeq 8\times 10^{13}$. In the ultimate state we found $Re_{{\it\theta}}\propto Ra^{0.40\pm 0.03}$. Recently, Skrbek & Urban (J. Fluid Mech., vol. 785, 2015, pp. 270–282) claimed that non-Oberbeck–Boussinesq effects on the Nusselt and Reynolds numbers of turbulent RBC may have been interpreted erroneously as a transition to a new state. We demonstrate that their reasoning is incorrect and that the transition observed in the Göttingen experiments and discussed in the present paper is indeed to a new state of RBC referred to as ‘ultimate’.
Neuropeptidase activities in plasma after acute restraint stress. Interaction with cortico-limbic areas
Authors: Segarra Ana Belén , Hernández Joaquín , Prieto Isabel , de Gasparo Marc , Ramírez-Sánchez Manuel
Published: February 2016

Objective

To evaluate the influence of acute restraint stress (ARS) on plasma enkephalinase and oxytocinase activities. ARS modifies basal activities in cortico-limbic regions of rats and induces changes in the correlations observed between these regions. The interactions between plasma and cortico-limbic activities will be also evaluated.

Methods

Enkephalinase (AlaAP and LeuAP) and oxytocinase (P-LeuAP) activities were fluorometrically determined in plasma of control and stressed rats using aminoacyl-β-naphthylamides (aaNNap), AlaNNap and LeuNNap as substrates.

Results

No differences in enzymatic activities were observed between control and stressed animals in plasma. In contrast, highly significant positive and negative correlations between plasma and cortico-limbic regions were demonstrated in controls. Stress conditions significantly alter the pattern of these correlations.

Conclusion

The present results clearly support a connection between plasma and brain involving certain neuropeptidase activities that change under stress conditions.
Corporate Personality: Myth, Fiction or Reality?
Authors: Bouckaert Boudewijn
Published: February 2016

1. When touching upon the question of the nature of corporate personality most lawyers will at best make a link with some paragraphs from the introduction to their commercial law course. They will remember that during the nineteenth century fierce theoretical battles were fought on questions such as whether we should treat supra-individual and non-individual entities as “persons”, under what conditions we should recognize their personality and what should be the legal consequences of such recognition. But no matter how interesting this debate must have been, to revive it is tantamount to becoming a public menace. Already in 1953 H.L.A. Hart, certainly an authority on legal theory, declared that “the juristic controversy over the nature of corporate personality is dead”. In many respects this assessment is correct. Despite the numerous differences about the conditions of recognition, about the possible types of corporations and associations which are subject to corporate personality, about the solidity of the corporate veil, we can observe that nearly all legal systems in the world adopt the notion of corporate personality as such. We may assume the notion will become even more important in the former socialist world, as these countries try hard to reshape their economies along the lines of the market economies in the Western world.
“Is There Justice? No — Just Us!”
Authors: Steinert Heinz
Published: February 2016

I found the slogan used as the title of this paper one sunny and cold Sunday morning in winter, 1985, on a vertical steel bar in the middle of the Brooklyn Bridge, above the East River, written with that ugly black ink that has replaced the bright colours of earlier years of graffiti in New York. Still, in contrast to the meaningless scribblings or markings of warrior names usually found in Manhattan these days, the message is nearly a joyful one: there is no point in expecting or demanding a “just society” from a state or other authorities — we will have to look after that ourselves and we can do it. By implication the writer also tells us what popular demands for “justice” really mean: an end to injustice. They are not “positive” demands, but in fact criticisms of some state of affairs or measures taken (or not taken) by the authorities: we know very well what is not just, even though we may not know what a “just” society should look like, and may even be sceptical whether we would like to live in one.
Punishment: Civil Style — A Comment
Authors: Goldstein Stephen
Published: February 2016

I am honoured and pleased to comment on the paper on “Punishment Civil Style” by my good friend Marc Galanter, with whose basic thesis I am in complete agreement. I would take as my starting point and, indeed, emphasize, Galanter's definition of punishment as the “imposition of a harm, injury, deprivation or other bad thing on someone on the ground of some commission of some offence. The infliction of harm on the offender may be viewed as a goal (or a proximate to a goal of justice) or it may be viewed instrumentally as a mean to social betterment through rehabilitation, incapacitation, deterrence, reassurance, and so forth”.

Galanter well points out that, as such, punishment is not limited to the criminal justice system, but is employed also in other societal systems, including that of civil justice.

Yet, I fear that he may mislead us in focusing in his paper so heavily on punitive damages, which he maintains “are the most visible and clearly legitimated manifestation” of the principle of “civil punishment”.
A murine model of subglottic granulation
Authors: Ghosh A , Leahy K P , Singhal S , Einhorn E , Howlett P , Cohen N A , Mirza N
Published: February 2016

Objective:

This study aimed to develop a functional model of subglottic stenosis by inducing direct airway irritation in transplanted mouse laryngotracheal complexes.

Methods:

Laryngotracheal complexes from C57BL/6 mice were harvested and divided into three groups: uninjured, mechanically injured and chemically injured. Donor laryngotracheal complexes from each group were placed in dorsal subcutaneous pockets of recipient mice. Each week, the transplanted laryngotracheal complexes were harvested, and tissues were fixed, sectioned, and stained with haematoxylin and eosin. Representative slides were reviewed by a blinded pathologist, to determine the formation of granulation tissue, and graded as to the degree of granulation formation.

Results:

Direct airway irritation induced granulation tissue formation under the disrupted epithelium of airway mucosa; this was seen as early as two weeks after chemical injury.

Conclusion:

Results indicate that granulation tissue formation in a murine model may be an efficient tool for investigating the development and treatment of subglottic stenosis.
LA SEDA CHINA EN NUEVA ESPAÑA A PRINCIPIOS DEL SIGLO XVII. UNA MIRADA IMPERIAL EN ELMEMORIALDE HORACIO LEVANTO
Authors: Bonialian Mariano
Published: February 2016

This article analyzes the effects generated by the import and consumption of madeja silk from China in the commercial and productive level of Mexico and Spain between 1580 and 1620. The paper questions the traditional image of an Asian trade defined by expensive, manufactured goods, oriented to an elite consumption. Considering the Memorial of Horacio Levanto (1620) and in the context of modern globalization, we propose the hypothesis that Asian trade responded to mass consumption, influencing productive structures in New Spain and Spain herself. Madeja silk from China was one of the main semi-processed goods imported via Acapulco which, as raw material, promoted the development of the Novohispanic textile industry.
Temporal Lobe Epilepsy Surgery in Childhood: Rationale for Greater Use
Authors: Blume Warren T.
Published: February 2016

Anterior temporal resection may effectively relieve therapy-resistant seizures in children and give social, psychological and economic benefits. Epidemiological and prognostic data demonstrate that this is an under-utilised procedure: although an estimated 677 Ontario children per year would be candidates for anterior temporal resection, only 18 were performed in a 12 month period.
Somatosensory Evoked Potential Identification of Sensorimotor Cortex in Removal of Intracranial Neoplasms
Authors: Rowed David W. , Houlden David A. , Basavakumar Devsur G.
Published: February 2016

Objective:

To assess the ease and reliability of routine use of somatosensory evoked potentials (SSEPs) for identification of sensorimotor cortex in brain tumour removal and to document its influence on the performance and outcome of surgery.

Methods:

SSEPs in response to contralateral median nerve stimulation were recorded from the cortical surface by means of a four lead electrode strip. Polarity reversal of short latency SSEP waves was used to identify the position of the central sulcus in 46 consecutive craniotomies for removal of metastases, gliomas, or meningiomas located in, near, or overlying sensorimotor cortex.

Results:

SSEPs were successfully recorded in 43/46 cases (94%) with demonstration of polarity reversal in 42/43 (98%). SSEP localization led to modification of 14/42 (33%) procedures, most frequently because of either displacement or involvement of sensorimotor cortex by tumour. Six patients (14%) developed new neurological deficits but none of these was attributable to incorrect identification of sensorimotor cortex.

Conclusions:

SSEP polarity reversal is a simple, reliable, accurate, and inexpensive method of localizing sensorimotor cortex under general anaesthesia. Correct identification is possible when sensorimotor cortex is displaced or when surface anatomy is obscured by tumour. Routine use of this technique should be considered in all procedures for lesions located near the central sulcus.
Neuropathological Changes in Chronic Adult Hydrocephalus: Cortical Biopsies and Autopsy Findings
Authors: Del Bigio Marc R. , Cardoso Erico R. , Halliday William C.
Published: February 2016

Background:

The cortical changes resulting from chronic hydrocephalus in adults are not well defined.

Methods:

Retrospective analysis of twenty-one patients (age 64-88 years) with a clinical diagnosis of “normal pressure hydrocephalus” who underwent cortical biopsy at the time of intracranial pressure monitoring or shunt insertion, and eight patients who were biopsied but not shunted. Eleven brains (age 26-92 years), seven from patients who could be considered to have “normal pressure hydrocephalus”, were also examined following autopsy. Age- and sex-matched control brains with small ventricles and no history of dementia were compared to the hydrocephalic brains. Senile plaques and neurofibrillary tangles were assessed semiquantitatively and a non-parametric statistical analysis was employed.

Results:

Five biopsies exhibited both senile plaques and rare neurofibrillary tangles, while two had only neurofibrillary tangles. Neurofibrillary tangles were more prevalent in hydrocephalic brains than in controls. There was no difference in the prevalence of senile plaques between the two groups. Grumose bodies in the substantia nigra were identified in five autopsy brains, a prevalence higher than in control brains.

Conclusions:

These pathological features are not specific for hydrocephalus; however, they suggest that long-standing ventriculomegaly is associated with degenerative brain changes in sites beyond the periventricular white matter. The presence of senile plaques in cortical biopsies from hydrocephalic patients does not appear to be a contraindication to shunting; however a prospective study in patients undergoing intracranial pressure monitoring would better address the issue.
Role of the Ipsilateral Motor Cortex in Voluntary Movement
Authors: Chen Robert , Cohen Leonardo G. , Hallett Mark
Published: February 2016

The ipsilateral primary motor cortex (M1) plays a role in voluntary movement. In our studies, we used repetitive transcranial magnetic stimulation (rTMS) to study the effects of transient disruption of the ipsilateral M1 on the performance of finger sequences in right-handed normal subjects. Stimulation of the M1 ipsilateral to the movement induced timing errors in both simple and complex sequences performed with either hand, but with complex sequences, the effects were more pronounced with the left-sided stimulation. Recent studies in both animals and humans have confirmed the traditional view that ipsilateral projections from M1 to the upper limb are mainly directed to truncal and proximal muscles, with little evidence for direct connections to distal muscles. The ipsilateral motor pathway appears to be an important mechanism for functional recovery after focal brain injury during infancy, but its role in functional recovery for older children and adults has not yet been clearly demonstrated. There is increasing evidence from studies using different methodologies such as rTMS, functional imaging and movement-related cortical potentials, that M1 is involved in ipsilateral hand movements, with greater involvement in more complex tasks and the left hemisphere playing a greater role than the right.
Hormones, Radiosurgery and Virtual Reality: New Aspects of Meningioma Management
Authors: Black Peter McLaren
Published: February 2016

The understanding and management of meningiomas is changing significantly today. One of the most striking features of their pathophysiology is their predominance in women. In a series of 517 patients with meningiomas seen by the Brain Tumor Group at Brigham and Women's Hospital, the female:male ratio was 2.4:1. The progesterone receptor appears to be the major candidate to explain this difference. Although meningioma cells variably express receptors for estrogen, androgen, platelet-derived growth factor, epidermal growth factor, and somatostatin, these molecules do not explain the differences because they are not differentially expressed or are not activated. Progesterone receptor can be shown to be expressed in 81% of women and 40% of men with meningiomas; it can also be shown to be activated by transfecting a construct with the progesterone responsive element and a reporter in it and using the cell's own receptors to activate this construct. Surgery remains the mainstay of meningioma management. At the Brigham and Women's Hospital three-dimensional reconstruction techniques have markedly improved the ability to visualize the tumor as well as its relation to vascular structures. With MRI reconstruction, it is possible to know the tumor's relation to the sagittal and other sinuses, to identify feeders and proximity to major arteries, and to establish its location and relation to cortex by frameless stereotaxis. These techniques can be used in a virtual reality format are some of the most powerful in neurosurgery both for teaching and for the surgical procedure itself. External beam radiation has been shown by others to be an effective adjunctive treatment to prevent meningioma recurrence. Recently, linear accelerator radiosurgery and stereotactic radiotherapy have changed the pattern of radiation at our institution. In a series of 56 skull base meningiomas, for example, 95% were controlled (i.e., showed no growth) over a four year period. Fractionated focal radiation potentially offers the same control rate with fewer complications. With increasing understanding and treatment possibilities, meningiomas remain one of the most intriguing and challenging tumors in the nervous system.
Familial Intracranial Aneurysms: Recurrence Risk and Accidental Aggregation Study
Authors: Mathieu Jean , Hébert Gilles , Pérusse Louis , Prévost Claude , Cantin Léo , Bouchard Jean-Marie , DeBraekeleer Marc
Published: February 2016

Background:

The Saguenay-Lac-Saint-Jean (SLSJ) region is a geographically isolated area (population 285,955) located in the Northeastern part of the Province of Quebec, Canada. Using a population-based register, the genealogical reconstruction of 502 individuals with ruptured intracranial aneurysm (RIA) showed a familial aggregation (the presence of aneurysm in two or more first- to third-degree relatives) for 144 (28.7%) of them; this proportion is much higher than reported elsewhere.

Objective:

In order to assess the genetic predisposition to RIA in the SLSJ population, the objective of the present study is to compare familial and non-familial cases and to provide an estimate of the recurrence risk ratio for siblings.

Results:

The age at the time of rupture, the number of intracranial aneurysms for each patient and the location of RIAs were not statistically different in the familial versus the non-familial group. Of the 3449 siblings, 20 (0.58%) had suffered a RIA. The recurrence risk ratio calculated for siblings (defined as the risk of disease among siblings divided by the estimated population prevalence) is 1.6 (CI 95% 1.0 - 2.4). In other respects, we observed very large kinships in the SLSJ population, with an average number of siblings of 7.2 (SD ± 3.4), ranging from 0 to 17 individuals. With such large families and on the basis of chance alone, we expected 31.3% of the patients to have at least one first- to third-degree relative with RIA.

Conclusion:

These data show that siblings of patients with RIA in the SLSJ population have a greater risk of RIA than the general population. Nevertheless, the largest part of the familial occurrence observed in the SLSJ region can be explained by accidental aggregation, due to large kinships. We propose that, in this population, an underlying genetic predisposition must be suspected only when three or more cases of RIA are identified among first- to third-degree relatives.
Epilepsy and Driving: A Survey of Canadian Neurologists
Authors: McLachlan Richard S. , Jones Michael W.
Published: February 2016

Background:

A seizure is the most common cause of loss of driving privileges for medical reasons but there is variability in how physicians and the authorities who regulate driving approach this issue.

Methods:

A questionnaire regarding epilepsy and driving was sent to all adult neurologists in Canada (n = 494).

Results:

Of 289 (59%) neurologists responding, 50% usually report patients with seizures to the department of motor vehicles compared to only 4% for stroke/TIA, 26% for dementia and 8% for other neurologic disorders (p < 0.0001). In the five provinces with mandatory reporting laws, seizures were reported most of the time by 84% compared to only 19% in the five provinces with discretionary reporting (p < 0.0001). Nationwide, 44% agreed with mandatory reporting but this also differed in provinces with and without mandatory reporting legislation (63% vs. 37%, p < 0.0001). Only 49% agreed with the current recommendation of at least one year seizure free interval before resuming driving.

Conclusions:

Seizures are disproportionately reported compared to other neurological conditions. Many neurologists disagree with the recommended Canadian standards for duration of driving restriction after seizures. Variability in the attitude and practice of neurologists in regard to reporting of seizures is confirmed.
Episodic Cluster Headache in a Community: Clinical Features and Treatment
Authors: Riess C.M. , Becker W.J. , Robertson M.
Published: February 2016

Objective:

To study the clinical features and treatment given to episodic cluster headache patients in the Calgary region.

Patients:

Fifty-one (51) patients who responded to a media campaign, had previously been diagnosed by their family physicians, and who met International Headache Society (IHS) criteria for episodic cluster headache, formed the population for this study.

Methods:

The media campaign consisted of newspaper advertisements and radio publicity including physician interviews and talk shows. Patients were required to complete a 200-item questionnaire detailing clinical features and treatment of their cluster headache syndrome. Each patient was also interviewed by our research nurse for clarification and proper completion of questionnaire.

Results:

Fifty-one percent (51%) of our patients had short headache attacks lasting one hour or less. Almost one-half (45%) had three or four attacks per 24 hour period. Eighty-six percent (86%) had been referred to a neurologist. Sixty-nine percent (69%) had never used oxygen, but of those who had, onehalf were still using it. Sumatriptan by injection had been tried by 26% of patients and of these, 93% considered it effective. Subcutaneous dihydroergotamine had been tried by 8%. For prophylaxis, 41% had tried methysergide, 31% prednisone, and 4% verapamil. Many patients had been prescribed migraine prophylactic drugs which are ineffective for cluster headache, and some had also undergone dental procedures or nasal and sinus surgeries.

Conclusion:

Many cluster headache patients had not, to their knowledge, been prescribed or used the best symptomatic and prophylactic treatments for cluster headache. This should be addressed through educational programs and through making up-to-date information on the treatment of cluster headache readily available to physicians and patients.
Ras Activation in Astrocytomas and Neurofibromas
Authors: Guha Abhijit
Published: February 2016

Oncogenic mutations resulting in activated Ras Guanosine Triphosphate (GTP) are prevalent in 30% of all human cancers, but not primary nervous system tumors. Several growth factors/receptors are implicated in the pathogenesis of malignant astrocytomas including epidermal growth factor (EGFR) and platelet derived growth factor (PDGF-R) receptors, plus the highly potent and specific angiogenic vascular endothelial growth factor (VEGF). A significant proportion of these tumors also express a truncated EGFR, which is constitutively activated. Our work demonstrates that the mitogenic signals from both the normal PDGF-R and EGFR and the truncated EGFR activate Ras. Inhibition of Ras by genetic or pharmacological strategies leads to decreased astrocytoma tumorgenic growth in vitro and decreased expression of VEGF. This suggests that these agents may be potentially important as novel anti-proliferative and anti-angiogenic therapies for human malignant astrocytomas.

In contrast to astrocytomas, where increased levels of activated Ras GTP results from transmitted signals from activated growth factor receptors, the loss of neurofibromin is postulated to lead to functional up-regulation of the Ras pathway in neurofibromatosis-1(NF-1). We have demonstrated that NF-1 neurofibromas and neurogenic sarcomas, compared to non-NF-1 Schwannomas, have markedly elevated levels of activated Ras GTP. Increased Ras GTP was associated with increased tumor vascularity in the NF-1 neurogenic sarcomas, perhaps related to increased VEGF secretion. The role of Ras inhibitors as potential therapy in this tumor is also under study.
Mild Non-lesional Temporal Lobe Epilepsy: A Common, Unrecognized Disorder with Onset in Adulthood
Authors: Aguglia Umberto , Gambardella Antonio , Plane Emilio Le , Messina Demetrio , Oliveri Rosario L. , Russo Concetta , Zappia Mario , Quattrone Aldo
Published: February 2016

Objective:

To compare mild vs. severe non-lesional temporal lobe epilepsy (TLE).

Methods:

Data from 104 consecutive patients with non-lesional TLE were reviewed. Seventy-three of the 104 fulfilled the criteria for inclusion in this study of a follow-up period longer than three years at our Institute. Patients were considered to have a mild TLE if they were seizure free for at least three years after appropriate antiepileptic medication, or had rare (≤ 2/year) complex partial or secondarily generalized seizures for at least three years with or without appropriate antiepileptic therapy. Clinical, EEG and MRI data of mild vs. severe non-lesional TLE patients were compared on the basis of a cross-sectional study design.

Results:

Of the 73 patients with non-lesional TLE included in the study, 43 (59%) had mild TLE, and 30 (41%) had severe TLE. Duration of epilepsy was significantly shorter (mean 15.2 ± 10.5 years vs. 26.4 ± 13.2 years) and age at onset was significantly higher (mean 34.3 ± 15.3 years vs. 7.8 ± 6.8 years) in mild than in severe TLE group. Patients with mild TLE had also a significantly higher prevalence of positive family history of epilepsy (37.2% vs. 10%), and a significantly lower occurrence rate of febrile convulsions (FC) (4.7% vs. 33.3%), mesial temporal sclerosis (MTS) (6.9% vs. 36.7%), and intelligence deficiency (0% vs. 20%). In mild TLE there was also a significantly high rate (58.1% vs. 0%) of delayed diagnosis (from 1 to 28 years), because of misdiagnosis (39.5%) or no medical counseling (18.6%).

Conclusions:

Mild non-lesional TLE is a common, unrecognized disorder mainly characterized by both onset in adulthood and high prevalence of familial history of epilepsy. The present findings suggest that mild non-lesional TLE may represent a clinical entity different from severe non-lesional TLE.
Safety and Tolerability of Subcutaneous Cladribine Therapy in Progressive Multiple Sclerosis
Authors: Selby R. , Brandwein J. , O'Connor P.
Published: February 2016

Objective:

To evaluate the safety and tolerability of subcutaneous (s.c.) cladribine therapy in patients with chronic progressive multiple sclerosis (CPMS), and to evaluate the effects on lymphocyte subsets.

Background:

Cladribine, a synthetic antineoplastic agent with immunosuppressive effects, may favourably affect the course of CPMS. However results of a previous reported clinical trial showed significant myelosuppression in some patients.

Design/Methods:

19 patients with severe (mean extended disability status score [EDSS] = 6.7) CPMS were treated on a compassionate basis with cladribine 0.07 mg/kg/ day s.c. for 5 days per cycle, repeated every 4 weeks for a total of 6 cycles. Patients underwent clinical evaluation, EDSS, and hematologic analysis before, during, and following therapy.

Results:

The treatment was very well tolerated with no clinically significant side effects observed. Between baseline and the end of cycle 6, mean decreases were noted in absolute lymphocyte count from 1697 to 463 (p = 0.000012), CD4 count from 865 to 187 (p = 0.0000008), CD8 from 418 to 165 (p = 0.005) and CD19 from 197 to 26 (p = 0.000002). Platelet, granulocyte and RBC counts were unaffected. Approximately one year after completion of therapy, some recovery of CD4 and CD8 counts had occurred although both counts remained suppressed compared to baseline (302 and 227 respectively); the CD19 count had recovered essentially to normal by one year. EDSS scores post-therapy revealed some deterioration in 8 patients and stable scores in the remaining 11. Global patient evaluations of the treatment were mixed.

Conclusions:

Cladribine therapy, at lower doses than previously reported, was remarkably well tolerated in CPMS, with no significant myelosuppression. Profound effects occurred in total lymphocyte count and CD4, CD8 and CD19 subsets.
Segmental Hyperhidrosis as a Manifestation of Spinal and Paraspinal Disease
Authors: Schulz Valerie , Ward Donna , Moulin Dwight E.
Published: February 2016

Background:

Segmental hyperhidrosis is an uncommon finding which is usually associated with irritation or infiltration of pre-ganglionic sympathetic fibres or the sympathetic chain.

Methods:

We report two cases of segmental hyperhidrosis with striking clinical features.

Results:

In one case, a mesothelioma produced ipsilateral simultaneous underactivity and overactivity of sympathetic outflow and in the other case a thoracic central disc herniation was probably responsible for a band of sweating which clearly extended beyond the segmental level of injury.

Conclusion:

Segmental hyperhidrosis should trigger a search for structural disease in the spinal and paraspinal region.
A Measure of Peripheral Nerve Stimulation Efficacy Applicable to H-Reflex Studies
Authors: Boorman G.I. , Hoffer J.A. , Kallesoe K. , Viberg D. , Mah C.
Published: February 2016

Background: When H-reflexes are recorded during movement in human subjects, the stimulator current output is not a good indicator of sensory stimulation efficacy because of unavoidable nerve movement relative to the stimulus electrodes. Therefore, the M-wave amplitude has been used by researchers as an indicator of the efficacy of the stimulus. In this study we have examined the general validity of the hypothesis that the M-wave amplitude is directly proportional to the group I sensory afferent volley evoked by the stimulus. Methods: A nerve recording cuff, stimulating electrodes, and EMG recording electrodes were implanted in cats. Nerve cuff recordings of centrally propagating volleys evoked by electrical stimuli were directly compared to M-waves produced by the same stimuli. Compound action potentials (CAPs) recorded in the sciatic nerve were compared with soleus M-waves during either tibial nerve or soleus muscle nerve stimulation. CAPs in the ulnar nerve were correlated with flexor carpi ulnaris M-waves during ulnar nerve stimulation. Results and Conclusions: Our findings indicate that for mixed nerve stimulation (e.g., tibial or ulnar nerve) the M-wave can be a reliable indicator of the centrally propagating sensory volley. Due to the high correlation between CAP and M-wave amplitude in these nerves, a small number of M-waves can give a good estimate of the size of the group I sensory volley. On the other hand, when nerves with only partially overlaping fibre diameter populations are stimulated (e.g., the soleus muscle nerve), the M-wave is not well correlated with the group I sensory volley and thus may not be used as a measure of the size of the input volley for H-reflex studies.
Measurement of Health-Related Quality of Life in Multiple Sclerosis Patients
Authors: Brunei Donald G. , Hopman Wilma M. , Singer Michael A. , Edgar Catherine M. , MacKenzie Thomas A.
Published: February 2016

Background: Patient outcomes in multiple sclerosis (MS) have generally been measured by their neurological impairment using specific scales such as the Kurtzke Expanded Disability Status Scale (EDSS). However, this scale does not measure the multiple dimensions of health-related quality of life (HRQOL) such as functional status and general well-being, which are also important outcomes along with disease-specific measurements. Methods: HRQOL was measured in a group of 97 MS patients using the RAND 36-item Health Survey 1.0. The EDSS score was assigned by the clinic neurologist. Additional data were collected from the clinical record for each patient. Results: MS patients scored poorly in a number of HRQOL domains such as physical and role functioning and energy or vitality. Disability as quantified by the EDSS correlated only with the physical functioning domain. Regression models were developed to measure the relationship between patient characteristics (independent variables) and HRQOL domains (dependent variables). Discussion: A number of patient characteristics were associated with higher or lower scores on the HRQOL domains. Of particular interest is the finding that a family history of MS was associated with poorer physical and social functioning as well as more pain and less vitality. The occurrence of seizures had a negative impact on role functioning, social functioning and general health perceptions. HRQOL gives caregivers a broader measure of disease burden than the EDSS alone, and should be useful in planning and monitoring interventions.
Familial Parkinson’s Disease: A Clinical Genetic Analysis
Authors: Bonifati Vincenzo , Fabrizio Edito , Vanacore Nicola , Mari Michele De , Meco Giuseppe
Published: February 2016

Objective

To study the frequency, clinical features and clinical genetics of familial Parkinson’s disease (PD).

Methods

Family history for PD and tremors was studied in 100 consecutive PD cases. Spouses served as controls. Clinical features were compared between personally verified familial and sporadic PD cases, from the same consecutive clinical series. Clinical genetic analysis was performed in a larger group of non-consecutive multicase PD families.

Results

Family history for PD was positive in 24% of consecutive PD cases and in 6% of spouse controls (p < 0.001). When family history for isolated tremor is also considered, the number of positive cases rises to 43% compared with 9% in controls (p < 0.001). Nine of the consecutive cases had at least one living affected relative, for a total of 20 familial PD cases. These familial cases showed an earlier onset age when compared with sporadic ones from the same consecutive series. Within 22 non-consecutive PD families with at least two living and personally examined PD cases (total 52 PD cases), the crude segregation ratios were similar for parents and siblings and the lifetime cumulative risks approached 0.4 in siblings and tended to be comparable, but at later ages, in parents. Ancestral relatives were all unilaterally distributed. In some families, anticipation of onset age in new generations was observed.

Conclusions

The frequency of positive family history for PD and for PD and tremor is higher among PD cases than controls. Familial and sporadic PD only differ in onset age. The clinical genetic analyses support autosomal dominant inheritance with strongly age-related penetrance as most likely in familial PD.
Risk of Intracranial Aneurysms in Families With Subarachnoid Hemorrhage
Authors: Alberts Mark J. , Quinones Ana , Graffagnino Carmelo , Friedman Allan , Roses Allen D.
Published: February 2016

Background:

Genetic factors may be important in the etiology of subarachnoid hemorrhage (SAH) and intracranial aneurysm (IA) formation. Several studies have reported the familial occurrence of SAH and IA, although in most cases asymptomatic family members were not studied with elective angiography. The examination of data from large sibships could provide important information about the frequency of IA occurrence in at-risk individuals and the mode of inheritance for familial SAH/1A.

Methods:

We reviewed published case series of sibships with SAH and at least four siblings, in which at least one sibling underwent elective angiography. Data were collected on age-of-onset, clinical events, presence of hypertension, angiographic findings, and outcome. Patients were classified as “affected” if they had a SAH or if an IA was detected by elective angiography, and “unaffected” if they were asymptomatic and had a negative angiogram.

Results:

Seven case series with 52 individuals (26 men and 26 women) met our inclusion criteria. The sibships ranged from 6 to 13 members. Most of the siblings (32 of 52, 61%) were asymptomatic, 18 (35%) had a SAH, and 2 (4%) had focal symptoms but no SAH. Elective angiography of 34 siblings showed an IA in 11 (32%) and was negative in 23 (68%). The overall rate of affecteds (SAH or IA) was 56%.

Conclusions:

Based on data from these sibships, angiography of asymptomatic at-risk siblings demonstrated an IA in almost one-third of cases. Familial SAH/IA segregated with a pattern that was consistent with an autosomal dominant trait in this selected series of sibships, although other factors could produce these findings.
Bilateral Temporal Lobe MRI Changes in Uncomplicated Hypoglycemic Coma
Authors: Boeve B.F. , Bell D.G. , Noseworthy J.H.
Published: February 2016

We report bilateral temporal lobe MRI findings in a patient following an episode of prolonged hypoglycemia uncomplicated by coexisting anoxia, hypotension, acidosis, drug intoxication, infection, or status epilepticus. The MRI findings are discussed in relation to the experimental and human data on hypoglycemic neuronal injury.
Writer’s Cramp and Tremor Due to Brain Tumor
Authors: Milanov I. , Georgiev D.
Published: February 2016

Writer’s cramp is frequently associated with hand tremor and with other focal dystonias. Sometimes brain infarction, haemorrhage, arterio-venous malformations or tumors are found to cause symptomatic focal dystonias. A 44-year-old man came to our attention due to writer’s cramp of his right hand and postural 6-8 Hz tremor. About three months after the onset of the disease the tremor and dystonia disappeared, while a right hemiparesis gradually appeared. Cranial computed tomography showed a hypodense nonhomogeneous lesion in the left cerebral hemisphere parietally, that was assumed to represent a cystic tumor. The patient underwent craniotomy and the histological diagnosis revealed an astrocytoma (Grade II-III). In conclusion our findings confirm the common anatomical basis of symptomatic focal dystonia and tremor. Both can appear after disruption of the pathways within and adjacent to the basal ganglia.
Acute and Chronic Toxicity of Antiepileptic Medications: a Selective Review
Authors: Camfield Peter , Camfield Carol
Published: February 2016

Acute and chronic toxicity complicates all antiepileptic medications (AED) and is idiosyncratic. Acute toxicity can be categorized into 1) acute brain dysfunction or 2) acute organ dysfunction when AED’s are started. Despite promisingin vitrolymphocyte testing, anticipation of acute reactions cannot be offered. Furthermore, screening for AED toxicity by routine blood and urine tests in asymptomatic patients is of doubtful value and should be abandoned. Patients should be informed of possible reactions and immediately report early symptoms. Treatment for acute reactions is largely unstudied. It is unclear how to reintroduce AED’s following acute reactions. Often patients are sensitive to drugs with a similar chemical structure. The “desensitization” protocol of Purvis may be of merit. Three major chronic toxicities of AED’s have been noted – soft tissue and gum hypertrophy, progressive ataxia, and peripheral neuropathy. New AED’s require careful post-marketing surveillance since long term toxicity data are not yet available.
The Place of Neuronal Migration Abnormalities in Child Neurology
Authors: Aicardi Jean
Published: February 2016

With the development of modern imaging techniques, disturbances of neuronal migration appear to be a major cause of epilepsy, mental retardation and chronic neurological disability in childhood. Sixty-nine cases are presented, including 46 of diffuse migration abnormalities and 23 of localized dysplasia. Patients with diffuse migration disorders presented with mental retardation, gross motor impairment and severe seizure disorders whereas in those with focal anomalies, epilepsy was the chief complaint. Magnetic resonance imaging, although usually diagnostic of migration disorders often does not allow definition of the pathologic type. Some EEG patterns, such as high amplitude fast rhythms or the theta-delta pattern are highly suggestive. Most cases of abnormal migration are sporadic and probably acquired. Some are due to chromosomal anomalies, especially of chromosome 17p where a gene for lissencephaly has been mapped. Familial cases occur with both recessive and possibly dominant inheritance. Epilepsy due to migration abnormalities is often intractable. Resection of dysplastic cortex may be effective for localized disease and callosotomy has been proposed for diffuse anomalies.
The Influence of Sulindac on Experimental Streptozotocin-Induced Diabetic Neuropathy
Authors: Zochodne Douglas W. , Ho Lam T.
Published: February 2016

We studied the influence of sulindac, a nonsteroidal anti-inflammatory agent on experimental streptozotocin-induced diabetic neuropathy. Untreated diabetic rats were compared with nondiabetic rats, diabetic rats treated with low dose insulin and diabetic rats given sulindac (6.0 mg/kg by gavage 5 of 7 days weekly). Neuropathy was assessed by following serialin vivomotor and sensory caudal conduction, resistance to ischemic conduction failure, andin vitroconduction in sural myelinated and unmyelinated sensory fibers. The impact of low dose insulin and sulindac treatment on the microenvironment of the L4 dorsal root ganglion and sciatic endoneurium was asssessed by measuring local perfusion and oxygen tension after 16 weeks of diabetes. Sulindac normalized conduction velocity in caudal sensory fibers, sural myelinated fibers and sural unmyelinated fibers, and reduced the number of diabetic cataracts. Sulindac also normalized a deficit in dorsal root ganglion blood flow and a reduction in sciatic endoneurial oxygen tension in diabetic rats. Low dose insulin improved neuropathy as well but the pattern of benefits was less robust than that of sulindac. Sulindac may be a candidate for a clinical trial in human diabetic polyneuropathy.