bluuebunny/crossref_metadata_2025 huggingface dataset:
Role of Electrophysiological Studies in Diabetic Neuropathy
Authors: Bril Vera
Published: February 2016

Electrophysiological studies are a reproducible and noninvasive method of assessing peripheral nerve function. The sensitivity of these methods has been validated in population-based and clinical studies, and the variability of test results is typically lower than with other noninvasive tests of nerve function. It has been recommended that standardized procedures including temperature control and equipment calibration be utilized with electrophysiological testing. The failure to detect significant changes in nerve conduction studies from clinical studies may be due to poor standardization of technique and inadequate sample size to detect differences. Baseline results from a multicenter, randomized trial indicate that different electrophysiological measures are highly correlated and reproducible. This and future studies that incorporate standardized techniques and an adequate sample size should be able to detect significant differences between treatments and identify effective therapeutic interventions for diabetic neuropathy.
Traitement Medico-chirurgical du Mal de Pott de L’adulte. Notre Attitude au Gabon
Authors: Loembe Paul-Marie
Published: February 2016

Twenty-six of 95 adults treated for tuberculous spondylitis, between 1982 and 1993, underwent surgery. Twenty-one exhibited neurological deficits: radicular deficits: 4, and progressive spinal cord syndromes: 17 (incomplete: 13, complete, of acute onset: 4). Vertebral body compression fracture was the most prominent finding. Indications for surgery were neurologic: 11, mechanical: I, etiologic: 1, and mixed: 13. Twelve patients had vertebrectomies, 3 laminotomies and 11 laminectomies. The average follow-up was 23 months. The neurological recovery was complete in 16 cases, partial in 4 cases and unchanged in one case. Bony consolidation occurred after 3–5 months. The medicosurgical treatment produced a very high cure rate, so rapidly, that it became the treatment of choice in our setting. Moreover, that allows to specify the diagnosis. Anterior decompression and fusion is recommended in the cervical and lumbar spine. In the thoracic segment, significant kyphosis is infrequent, so that surgical correction is rarely necessary. Laminotomy may occasionally be indicated for posterior decompression for abscess. Laminectomy is now preferred for uncommon cases of thoracolumbar posterior compression by tuberculous arachnoiditis or associated posterior vertebral tuberculosis. Indications for open biopsy are discussed.
NMDA Receptor Blockade and Spinal Cord Ischemia Due to Aortic Crossclamping in the Rat Model
Authors: Follis F. , Miller K. , Scremin O. U. , Pett S. , Kessler R. , Wernly J.
Published: February 2016

Recent brain research proposes that, during ischemia, synaptically released excitatory amino acid neurotransmitters accumulate at toxic concentrations with ensuing neuronal death. Their action is mediated by the receptor subtype N-methyl-D-aspartate (NMDA). The protective effect of NMDA receptor blockade with intrathecal MgS04 and MK-801 was investigated during spinal cord ischemia induced by aortic occlusion of 12 minutes. Male Sprague-Dawley rats, 250-300g, underwent intrathecal administration of 20 μL of normal saline (SA n = 16), MgS04 1M (MG n = 16), or MK-801, 25 mM solutions (MK n = 16) in a randomized order. After 2 hours, the animals underwent occlusion of the thoracic aorta and subclavian arteries for 12 min. An additional control group (CO n = 16) underwent occlusion for 12 minutes, without intrathecal injection. The animals were scored according to their functional performance (LS = lesion score) each day for four days by a blinded observer. Mean LS were calculated for each group at a given day. Treatment and control groups were not different at day 1 (P = 0.302). Group MG was improved from groups SA (P = < 0.0039) and CO (P = < 0.0048) at day 4. This study demonstrates that although intrathecal NMDA receptor blockade with MgS04 or MK-801 does not prevent paraplegia due to spinal cord ischemia in the rat, it could however influence the rate of recovery after ischemic injury.
Large Unresponsive Zones Appear in Cat Somatosensory Cortex Immediately After Ulnar Nerve Cut
Authors: Li Cheng-Xiang , Waters Robert S. , Oladehin Akinniran , Johnson Eldridge F. , McCandlish Carl A. , Dykes Robert W.
Published: February 2016

The organization of the primary somatosensory cortex innervated by the ulnar nerve was studied before and immediately after ulnar nerve transection in 11 cats electrophysiologically mapped under Nembutal or Ketamine anesthesia. The cortex was reexamined a second time beginning 42 hr after nerve transection in four cats anesthetized with Nembutal. One additional sham-operated control was also mapped. The region of cortex formerly served by the ulnar nerve remained largely unresponsive to somatic stimulation independent of the type of anesthetic used during recording. Nonetheless, animals anesthetized with Ketamine had more new responsive sites in deafferented cortex following nerve cut than cats anesthetized with Nembutal. New responses, when observed, were evoked by stimulation of a region of skin adjacent to the region served by the ulnar nerve. These findings suggest that the immediate response to deafferentation of somatosensory cortex is a limited acquisition of novel responses restricted to a region immediately adjacent to cortex containing normal afferent input.
Assessment of Genetic Polymorphisms in DNA from Formalin Fixed Neurological Tissues
Authors: Mordila M. , Vaula G. , St George-Hyslop P.H.
Published: February 2016

The ability to analyze the genotype of deceased affected members of pedigrees segregating inherited neurological diseases considerably augments the informativeness of such pedigrees. This information has direct application in attempts to isolate disease genes by positional cloning strategies, and for genetic counselling. We show that the genotype at polymorphic simple sequence repeat loci can be determined from genomic DNA isolated from 10 micron thick paraffin embedded, formalin fixed neurological tissues. The critical constraint on this method is the size of the template target bearing the simple sequence repeat, which should ideally be less than 165 base pairs.
Fluoxetine and Selegiline – Lack of Significant Interaction
Authors: Waters C.H.
Published: February 2016

The use of the combination of fluoxetine, an anti-depressant serotonin uptake inhibitor, and selegiline, a monoamine oxidase -B inhibitor, was reviewed in a large population of patients with Parkinson’s disease. All records were reviewed from a Parkinson’s disease clinic to determine how many patients were treated simultaneously with selegiline and fluoxetine. Patient characteristics, duration and dose of treatment, side effects and reasons for discontinuation were noted. Twenty-three patients received both medications at the same time. No additional side effects were noted with the combination therapy that had not already been reported with each medication alone. No serious side effects were found. In this clinic population, fluoxetine and selegiline were used in combination without major side effects, but further observation is warranted.
A Controlled Trial of Mitoxantrone in Multiple Sclerosis: Serial MRI Evaluation at One Year
Authors: Bastianello S. , Pozzilli C. , D’Andrea F. , Millefiorini E. , Trojano M. , Morino S. , Gasperini C. , Bozzao A. , Gallucci M. , Andreula C. , Bozzao L. , Gambi D. , Prencipe M.
Published: February 2016

We present the results of a randomized double-blinded placebo controlled, multicenter trial, of low-dose mitoxantrone (MX), after one year, in 25 patients with relapsing-remitting multiple sclerosis, who had serial enhanced magnetic resonance imaging (MRI). Treatment groups were balanced for age, gender, duration of illness and neurological disability. Five of the 13 MX patients and 10 of the 12 placebo patients had exacerbations during treatment (p < 0.02). The mean change in the extended disability status scale was not significantly different between the MX and placebo treatment groups. Serial Gadolinium-DTPA enhancedMRIdetected no significant difference between the MX treated and placebo groups in the mean total number of new, enlarging, or Gadolinium-DTPA enhancing lesions; there was a trend toward a reduction of new, enlarging and Gadolinium-DTPA enhancing lesions in MX patients. Despite this ameliorating effect, the results indicate that serial Gadolinium-DTPA enhanced MRI, performed over one year in a limited number of patients, could not provide conclusive evidence for a role of MX therapy in relapsing-remitting multiple sclerosis.
Intractable Hiccup Due to Multiple Sclerosis: MR Imaging of Medullary Plaque
Authors: Chang Yung-Yee , Wu Hsiu-Shen , Tsai Tsung-Chia , Liu Jia-Shou
Published: February 2016

We describe a 31-year-old man with clinically definite multiple sclerosis who presented with intractable hiccup for one month prior to admission. The responsible lesion was confirmed by magnetic resonance imaging to be a plaque in the ventral paramedian portion of the medulla oblongata.
A Double-Blind Cross-over Trial of Amantadine Hydrochloride in Friedreich's Ataxia
Authors: Filla A. , De Michele G. , Orefice G. , Santarelli F. , Trombetta L. , Banfi S. , Squitieri F. , Napolitano G. , Puma D. , Campanella G.
Published: February 2016

We performed a double-blind cross-over study with amantadine hydrochloride in 12 patients with Friedreich's disease and 2 with autosomal dominant cerebellar ataxia. Patients were randomly assigned to a placebo-amantadine or amantadine-placebo sequence. The interval between the treatments was two weeks. Patients were graded according to a functional ataxia scoring scale and videotaped in basal conditions and 90 min after a single oral dose of 100 mg amantadine or placebo. Three evaluators independently scored the videotapes. Statistical analysis showed no significant effect of amantadine in Friedreich's disease.
Epidemiology and Clinical Features of Vestibular Schwannoma in Manitoba, Canada
Authors: Frohlich Arnold M. , Sutherland Garnette R.
Published: February 2016

The incidence of vestibular schwannoma (acoustic neuroma) in Manitoba, Canada was reviewed. From 1987 through 1991, 71 tumors were diagnosed in 69 patients. The overall annual incidence rate for both sexes was 1.27/100,000 with male and female annual incidences of 1.31/100,000 and 1.24/100,000 respectively. For males, there was an early peak in the age group 30 - 39 years (2.1/100,000). Following the fifth decade, the incidence for males plateaued (2.7 - 3.6/100,000). For females, the incidence increased with age up to age 60 - 69 years (4.1/100,000). This was followed by a progressive decline in the incidence. Although the incidence of vestibular schwannoma was relatively high, the clinical features were not unlike those previously reported in the literature.
Serum Lipoprotein Fatty Acid Profile in Hereditary Ataxias
Authors: Iorio L. , De Michele G. , Filla A. , Di Martino L. , Postiglione A. , Patti L. , Campanella G.
Published: February 2016

We investigated the serum fatty acid profiles of cholesterol esters, phospholipids and triglycerides in 24 patients with Friedreich's disease and 16 patients with other forms of spinocerebellar degeneration. In 8 patients with Friedreich's disease we also analyzed the fatty acid profile of the lipoprotein fractions. We found no major differences in fatty acid profiles between ataxic patients and sex and age-matched controls; in particular there was no decrease of linoleic acid in Friedreich's disease. The level of linoleic acid in serum cholesterol esters decreased with increasing disability of patients.
Dural Cavernous Hemangioma: An Under-recognized Lesion Mimicking Meningioma
Authors: James R. Perry , William S. Tucker , Mario Chui , Juan M. Bilbao
Published: February 2016

We report a 77-year-old woman who presented with partial seizures and was found to have an enhancing dural-based parietal convexity mass. The lesion enlarged on serial examination by computed tomography (CT) over a one year period. The clinical features and radiologic appearance were compatible with a pre-operative diagnosis of meningioma; however, pathologic findings were typical of a dural cavernous hemangioma. Accumulating evidence suggests that these lesions are an uncommon but distinct type of vascular malformation most often arising from the cavernous sinus, tentorium, or cerebello-pontine angle. With CT, magnetic resonance imaging and angiography, these lesions can closely resemble meningioma in terms of signal characteristics, enhancement pattern, and location. This is of importance both in the practical management of meningiomas where the diagnosis is often based on radiologic studies alone, and in clinical trials where incorrect entry diagnosis should be avoided.
Syrinx Extending from Conus Medullaris to Basal Ganglia: A Clinical, Radiological, and Pathological Correlation
Authors: Marc R. Del Bigio , John H.N. Deck , Kerry MacDonald J.
Published: February 2016

A 41-year-old woman with a history of birth injury to the brachial plexus suffered several delayed episodes of neurological deterioration. Magnetic resonance imaging studies revealed a syrinx extending from the conus medullaris into the brainstem and rostrally into both internal capsules. She died of an acute exacerbation of chronic respiratory failure. Autopsy demonstrated syringomyelia and syringobulbia with cavity extension bilaterally along the corticospinal tracts into the internal capsules. Islands of glial tissue in the subarachnoid space around the medulla caused obstruction of the subarachnoid space at the foramen magnum. These were probably the result of birth injury to the cerebellum. A detailed clinico-pathological correlation is provided to explain her neurological deficits. The pathogenesis of syrinx formation is discussed in terms of a late manifestation of birth trauma.
Pathogenic Mechanisms in Sporadic Amyotrophic Lateral Sclerosis
Authors: Andrew Eisen , Charles Krieger
Published: February 2016

In recognition of the 100th anniversary of Charcot’s death we have reviewed possible pathogenic mechanisms in amyotrophic lateral sclerosis (ALS). Advances in the last 5 years in molecular biology and genetics have identified mutations in the cytosolic dismutase (SODI) gene in some patients with familial ALS raising the possibility that oxidative stress may be involved in the pathogenesis. An excitotoxic pathogenesis has been implicated based on elevated plasma and CSF levels of amino acids and altered contents of amino acids in the nervous system of ALS patients and changes in the number of excitatory amino acid receptors. ALS sera containing antibodies to L-type calcium channels and the development of immune mediated lower and upper and lower motor neuron models have revitalized research efforts focusing on an immune basis for ALS. Other pathogenic mechanisms which have been the subject of recent research include elemental toxicity, apoptosis and programmed cell death and possibly a deficiency or abnormality in growth factors. Pathogenic processes for ALS must account for an increasing incidence of ALS, male preponderance, and the selective vulnerability of the corticomotoneuronal system.
Anti-Glutamate Therapy in Amyotrophic Lateral Sclerosis: A Trial Using Lamotrigine
Authors: Andrew Eisen , Heather Stewart , Michael Schulzer , Donald Cameron
Published: February 2016

Glutamate excitotoxicity is implicated in the pathogenesis of amyotrophic lateral sclerosis (ALS). We report the results of a double blind, placebo controlled, trial using 100 mg of oral daily lamotrigine (3,5-diamino-6-(2,3 dichlorophenyl)-l,2,4-triazine) which inhibits glutamate release. 67 patients were entered and at trial termination of 1.5 years 15 had withdrawn (9 active and 6 placebo) and 12 had died (6 active and 6 placebo). Mean age at entry was 57.5 years for the active and 58.6 years for the placebo groups. Patients were seen at 3 monthly intervals and scored according to neurological deficit based upon age of onset, bulbar and respiratory involvement, ambulation and functional disability. The mean change in clinical scores for the active versus placebo groups over the trial period was 7.1 ± 3.3 and 9.0 ± 3.3 respectively (0.05 < p < 0.10). Changes in cortical threshold and MEP/CMAP ratios to magnetic stimulation also did not differ significantly between the two groups. We conclude that lamotrigine in the doses administered does not alter the course of ALS.
HTLV-I Associated Myelopathy: An Endemic Disease of Canadian Aboriginals of the Northwest Pacific Coast
Authors: Joël J.F. Oger , Denise H. Werker , Dean J. Foti , Gregory A. Dekaban
Published: February 2016

Human T-cell lymphotropic virus type 1 (HTLV-I) is responsible for HTLV-I associated myelopathy or tropical spastic paraparesis (HAM/TSP) and for adult T-cell leukemia/lymphoma (ATLL). Both diseases have been well described in individuals living in Japan, West Indies, Seychelles Islands and Columbia where infection with HTLV-I is considered endemic and in persons whose descendants originated from these endemic areas. We report here 4 cases of HAM/TSP in 4 natives from 4 different tribal groups from British Columbia (B.C.). These are the first case reports of HTLV-I linked diseases found among North American Aboriginals. Possible routes of infection for HTLV-I infection included sexual transmission, breast feeding, blood transfusions and IV drug use. The seroprevalence of HTLV-I in North American Native population is unknown and we suggest that it is endemic in this ethnic group.
Abstracts of the Fifth International Conference on Computerized and Quantitative EMG
Authors: Alan J. McComas
Published: February 2016

The Conference was held in Hamilton, Ontario, on May 18-21 1993, and was the successor to the meetings in New York, Monaco, Cyprus and Mainz. Normally the conferences are held every two years but in this instance the event had been deferred to as not to clash with the 1992 International Congress of EMG and Clinical Neurophysiology in Jerusalem. The Hamilton meeting had been immediately preceded by the International Course on Single Fiber EMG and Other Special Techniques and over 150 registrants and faculty attended the two events. A noted absentee was Dr. Erik Stalberg (Uppsala), the pioneer of single fiber EMG, who was unexpectedly taken ill shortly before the meetings began; by the unanimous decision of the participants, both the International Course and the International Conference were dedicated to Dr. Stalberg.
In Search of the Identity of the Cerebellar Climbing Fiber Transmitter: Immunocytochemical Studies in Rats
Authors: Nianhui Zhang , Ole P. Ottersen
Published: February 2016

Quantitative immunogold cytochemistry at the electron microscopic level was used to assess the endogenous contents of glutamate, aspartate, homocysteic acid, and glutamine (a precursor of glutamate) in the cerebellar climbing fiber terminals. Of the three excitatory amino acids, only glutamate appeared to be enriched in these terminals. The climbing fiber terminals also displayed immunoreactivity for glutamine. The level of aspartate immunoreactivity was far higher in the nerve cell bodies in the inferior olive than in their terminals in the cerebellar cortex. Homocysteic acid immunolabelling was concentrated in glial cells including the Golgi epithelial cells in the Purkinje cell layer. Our immunocytochemical data indicate that glutamate is a more likely climbing fiber transmitter than aspartate and homocysteic acid.
Modulation of Monoaminergic and Amino Acid Transmission as a Means for Therapeutic Intervention in Ataxia
Authors: Andreas Plaitakis
Published: February 2016

In recent years, substantial progress has been made in understanding the organization and function of the cerebellum at the neuronal, synaptic, and molecular level. More than any other region of the brain, the cerebellum utilizes amino acids as its main excitatory and inhibitory transmitters. Excitatory amino acids, such as glutamate and aspartate, in addition to serving as chemical messengers, may also mediate neurodegenerative processes in human ataxic disorders. Of the monoamines, serotonin has been proposed as a neuromodulator in the cerebellum and is thought to play a role in the pathophysiology of ataxia in animal models, and human cerebellar disorders. These considerations raise the possibility that pharmacologic modification of amino acid and serotonergic transmission may provide a means for therapeutic intervention in ataxia.
Pathophysiology of Cerebellar Dysfunction in the Wernicke-Korsakoff Syndrome
Authors: Roger F. BuutterWoth
Published: February 2016

Cerebellar ataxia is a common presenting sign in the Wernicke-Korsakoff syndrome (WKS). Recovery from ataxia following thiamine treatment is rarely complete, suggesting the existence of both a reversible (“biochemical”) lesion as well as irreversible, neuropathological damage. Cerebellar pathology in WKS includes severeloss of Purkinje cells in superior cerebellar vermis as well as neuronal loss from the granular layer. In addition, damage to inferior olivary nucleus could result in loss of climbing fibre input to cerebellum in this condition. Experiments using an animal model of WKS, the pyrithiamine-treated rat, reveal selective reversible decreases of α-ketoglutarate dehydrogenase (αKGDH) in cerebellum. Decreased enzyme activities are associated with decreased cerebellar content of GABA and aspartate. Thiamine reversal of neurological symptoms results in normalization of cerebellar enzyme activities and GABA content suggesting that reduced activities of αKGDH constitute “the biochemical lesion” in these animals. Possible mechanisms implicated in neuronal cell death in cerebellum include impaired cellular energy metabolism, focal lactic acidosis and excitotoxic damage resulting from excess glutamate release mediated by Nmethyl-D-aspartate (NMDA) receptors. Similar mechanisms could be involved in the reversible and irreversible neurological symptoms of WKS in humans.
Femoral Neuropathy in Renal Transplantation
Authors: Jog Mandar S. , Turley Jean E. , Berry Henry
Published: February 2016

Acute femoral neuropathy after renal transplantation is an uncommon and rarely recognized complication. Recovery of the nerve is usual. Although rare, five cases have come to our attention in the past twenty years. A detailed clinical and electrophysiological analysis with a six month follow-up is presented. A review of sixteen other reported cases is also provided. The possible pathophysiology including direct compression and nerve ischemia, is discussed. We believe that nerve ischemia, possibly caused by a steal phenomenon, occurs in all cases following the anastomosis of the graft renal artery to the internal iliac artery, with a superimposed component of compression in some cases. The severity of ischemia probably determines the degree of recovery.
Usefulness of Single Fiber EMG for Distinguishing Neuromuscular from Other Causes of Ocular Muscle Weakness
Authors: Ukachoke C. , Ashby P. , Basinsk A. , Sharpe J.A.
Published: February 2016

Consecutive patients (n = 114), who had single fiber electromyography of the frontalis muscles for symptoms suggestive of ocular myasthenia gravis, were followed up for a mean of 14 months (3-64 mos). At follow up, based on strict criteria, 23 patients were classified as having ocular myasthenia gravis, 8 patients were diagnosed as having mitochondrial myopathy or oculopharyngeal dystrophy, 18 patients were found to have other diseases and 65 patients remained without a definite diagnosis. The single fiber electromyography data of these patients were then reviewed. The patients with ocular myasthenia gravis had, on average, more than 7/20 single fiber pairs with jitter > 45 μs and mean jitter of 56 μs. The 8 patients with mitochondrial myopathy or oculopharyngeal dystrophy had an average of 5/20 single fiber pairs with jitter > 45 μs and a mean jittter of 52 μs and could not be separated from the group with ocular myasthenia gravis on the basis of the single fiber electromyography results. The 18 patients with definite other diagnosis had an average of less than 1/20 single fiber pair with jitter > 45 μs and a mean jitter of 25 μs. This group could be clearly separated from the group with ocular yasthenia gravis. We conclude that single fiber electromyelography is useful in the separation of ocular myasthenia gravis from other causes of oculomotor weakness except mitochondrial myopathy and oculopharyngeal dystrophy.
Unusual Evolution and Computerized Tomographic Appearance of a Gliosarcoma
Authors: Preul Mark C. , Espinosa Jose A. , Tampieri Donatella , Carpenter Stirling
Published: February 2016

A patient with a remote infarct, seizures, mild hemiparesis, and dysphasia became obtunded over four months and died. Computerized tomography (CT) over 5 years showed a consistent, large, wedge-shaped left hemisphere hypodensity with a central calcification, but without signs of mass effect. This was interpreted as an infarct of the left middle cerebral artery territory. Post-mortem examination of the brain revealed the entire area appearing as infarct on CT was a gliosarcoma. We suspect that the unusual CT appearance of the lesion was likely caused by multiple pathologies: a low grade glioma transforming into a gliosarcoma that was able to spread throughout the area of infarct encephalomalacia without revealing a typical CT appearance of mass effect. The patient's brief period of deterioration probably coincided with transformation of the tumor into a gliosarcoma. The variable CT characteristics of gliosarcomas are reviewed.
A Qualitative Study of Attitudes Toward Error in Patients Facing Brain Tumour Surgery
Authors: Bernstein Mark , Potvin Dawn , Martin Douglas K.
Published: February 2016

Background:

Medical error is an extremely important component of patient safety and requires intense study. The present investigation undertook to examine patients' perceptions and attitudes regarding medical error.

Methods:

Qualitative case study methodology was used. We conducted 30 face-to-face interviews with patients within one week of undergoing a neurosurgical operation for a brain tumour. Interviews were audiotaped and transcribed and the data subjected to thematic analysis.

Results:

Three overarching themes emerged from the data: 1) trust in the patient's surgeon was of paramount importance; 2) patients'views toward medical error varied between fear and vulnerability to no concern; and 3) discussion of error was felt to be beneficial as it could help the medical profession decrease future errors and could help dispel the patient's fear and anxiety about the upcoming surgery.

Conclusions:

Patients'trust in their physician/surgeon is of paramount importance in allaying their fears about the possible occurrence and impact of medical error during their treatment. The level of concern about error varies among patients, but most felt that discussion of error was a good thing.
Medical and Cognitive Outcome in Children with Traumatic Brain Injury
Authors: Campbell Craig G.N. , Kuehn Sally M. , Richards Pauline M.P. , Ventureyra E. , Hutchison James S.
Published: February 2016

Background:

Head injury is an important cause of morbidity and mortality in pediatrics. Comprehensive studies on outcome are scarce despite significant clinical concern that multiple areas of functioning may be impaired following moderate to severe head injury. The literature suggests that sequelae include not only medical problems but also impairments in cognitive functioning.

Methods:

Aretrospective medical and psychology chart review of patients, age 1-18 years, admitted to the Children's Hospital of Eastern Ontario with moderate (Glasgow Coma Scale [GCS] 9-12) or severe head injury (GCS ≤ 8) from November 1, 1993 until December 31, 1998 was conducted. Correlations were performed between medical variables (i.e., GCS, Pediatric Risk of Mortality [PRISM] III score, duration of ICU and hospital stay) and measures of intelligence and memory functioning.

Results:

Eighty-three children age 1 to 18 were included. Seventy percent of the children were classified as having a severe head injury. There was a mortality rate of thirteen percent. Younger age at injury, lower GCS, and higher PRISM III scores predicted higher mortality. Medical complications were documented systematically. Forty-four patients underwent at least one cognitive assessment and 17 of these children had intelligence testing at three points in time: baseline (< four months), early recovery (five to 15 months) and follow-up (16 to 38 months). The mean intelligence and memory scores fell within the average range at the latest point in follow-up. For those children who underwent three serial assessments, the mean verbal and performance IQ fell within the low average range at baseline improving significantly to fall within the average range by early recovery. Continued improvements were apparent in verbal memory beyond early recovery, with the mean obtained at follow-up falling within 1 SD of the normative mean. Despite the return to normal ranges for the group means the proportion of scores falling below 1.5 standard deviations from the mean was greater than population norms for verbal IQ, performance IQ and verbal memory. Lower GCS scores and longer duration of stay in ICU or hospital were predictive of lower nonverbal intelligence. Lower GCS was also predictive of lower visual memory scores.

Conclusions:

This study describes a population of Canadian children who suffered moderate or severe traumatic brain injury. Initial GCS was the best predictor of mortality and cognitive outcome. These children demonstrated a temporal improvement in intelligence and memory functioning, with their mean performance on these cognitive measures falling within the average range at 16 to 38 months postinjury, although there was considerable variability in the outcomes between individuals.
A Blood-Brain Barrier Disruption Model Eliminating the Hemodynamic Effect of Ketamine
Authors: Fortin David , Adams Robert , Gallez Ariane
Published: February 2016

Objective:

We propose a simple modification to an established blood-brain barrier disruption (BBBD) animal model that allows us to use ketamine/xylazine as the anaesthetic agent, therefore decreasing the complexity and the cost of the model, while maintaining similar efficiency.

Methods:

Sixty-two Long Evans rats were anaesthetized by intraperitoneal injection of ketamine/ xylazine. Osmotic BBBD was performed by administering 25% mannitol into the internal carotid artery in a retrograde fashion from the external carotid. The infusion rate of mannitol, as well as the duration was adjusted in a stepwise fashion to identify optimal parameters for BBBD and minimize complications. As a supplementary step to previously reported models, a vascular clip was applied to the common carotid artery prior to the infusion of mannitol, therefore isolating our model system from the depressant hemodynamic effects of ketamine/xylazine. Evans blue dye was used to control for BBBD intensity.

Results:

Using this model at an initial infusion rate of 0.15 ml/sec, a significant incidence of brain hemorrhage (75%) and a death rate of 62.5% were observed. Decreasing the infusion rate in a stepwise fashion, 0.08 ml/sec was found to produce optimal BBBD, as demonstrated by Evans blue staining. At this rate, 6/7 animals depicted grade II staining, whereas one animal depicted grade IV.

Conclusion:

The application of a clip to the common carotid artery prior to mannitol infusion allowed us to isolate the cerebral circulation from the depressant hemodynamic effects of ketamine/xylazine. This supplementary step produced consistent and efficient BBBD in our animal model.
Functional MRI Study of Verbal Fluency in a Patient with Subcortical Laminar Heterotopia
Authors: Keene Daniel L. , Olds Janet , Logan William J.
Published: February 2016

Rationale:

Double cortex syndrome is a malformation in which there is a band of subcortical heterotopic grey matter separated from the cortex by white matter. The functional activity of the heterotopic neurons is unclear.

Patient:

A 13-year-old female was evaluated for seizures. The EEG showed bifrontal spike wave disturbance. Band heterotopia, in association with mild reduction of sulcation of the cerebral hemispheres, was found on MRI. Psychological assessment indicated the presence of variable cognitive abilities, with verbal IQ [82] generally better than nonverbal IQ [59], and specific difficulties in language comprehension and mathematics.

Method:

Functional MRI was used to localize the areas of language and motor activation. The language activation paradigm was a visual verb generation task with a visual fixation baseline. The motor paradigm consisted of alternating blocks of sequential finger tapping and rest. Coronal functional and anatomical images were obtained.

Results:

The motor paradigm produced activation of the primary motor cortex, the band heterotopia and the supplementary motor cortex. The language paradigm produced activation of the left inferior frontal gyrus and left supplementary motor area, but not of the band heterotopia.

Conclusions:

The activation of heterotopic grey matter during a motor task demonstrates a hemodynamic association with motor activity and suggests that this tissue may be functional. Such association was not seen with the language task. We speculate that later maturing functions such as language are restricted in their development to the normal situated superficial cortex in our patient.
Devic's Neuromyelitis Optica Treated with Intravenous Gamma Globulin (IVIG)
Authors: Bakker Jacqueline , Metz Luanne
Published: February 2016

Background:

Devic's syndrome is a demyelinating disease of the spinal cord and optic nerves. It tends to have a poor prognosis, probably due to the occurrence of necrosis within lesions. There is no proven effective treatment although relapses are commonly treated with corticosteroids and people with recurrent attacks may be managed with chronic immune suppressing treatments. Intravenous gamma globulin (IVIG) and plasma exchange are reasonable treatment options because Devic's syndrome is believed to be antibody mediated. We report two patients of Devic's syndrome that stabilized following initiation of monthly IVIG.

Patient 1:

A 42-year-old woman with a 23 year history of Devic's syndrome continued to have frequent attacks of optic neuritis unresponsive to daily corticosteroids and azathioprine. Since initiation of monthly IVIG 5/2 years ago she has had no further definite attacks. She has also noted minimal improvement in color perception.

Patient 2:

A 58-year-old woman with a three year history of Devic's syndrome experienced five attacks during the first 16 months of disease. Monthly IVIG was associated with complete cessation of relapses and significantly improved neurological status over one year of treatment.

Conclusions:

Because active Devic's disease often results in severe, permanent neurological impairment, preventive intervention should be considered. These cases suggest that IVIG may be effective in preventing attacks and possibly in enhancing neurological recovery. Randomized controlled trials will be needed to confirm this and to determine optimal dosing and treatment duration.
Neurologic Signs Predict Periventricular White Matter Lesions on MRI
Authors: Bae Charles J. , Pincus Jonathan H.
Published: February 2016

Objective:

Periventricular white matter disease (PVWD) is associated with abnormalities on tests that involve complex cognitive processes, along with an increased risk of cerebrovascular events which are associated with significant morbidity in older patients. This study investigates whether the neurological examination can predict the presence of PVWD on magnetic resonance imaging (MRI). No prior studies have assessed whether the neurological examination can predict the presence of PVWD on MRI.

Methods:

A focused neurological examination was performed on a random selection of patients referred for a MRI of the brain. Staff neuroradiologists who were blinded to the results of the physical examination independently read the MRI scans. The MRI interpretations were divided into four categories based on the degree of PVWD: none, mild, moderate, severe.

Results:

Twenty-three subjects had some degree of PVWD, while 25 subjects had none. The total number of neurologic signs correlated significantly with the severity of PVWD even when adjusting for the effect of age (rho=0.67, p<0.001). Ninety-one percent of subjects with PVWD had three or more abnormal signs, while 76% of subjects without PVWD had fewer than three. Abnormalities with the three step motor sequencing and horizontal visual tracking tests were maximally predictive of PVWD. One or both of these tests were abnormal in 96% of subjects with PVWD, while 64% of subjects without PVWD had no problems with either test.

Conclusion:

Simple neurologic tests can predict the presence or absence of PVWD on MRI.
Novel plate-stratiform nanostructured Bi12O17Cl2 with visible-light photocatalytic performance
Authors: Zhao Mei , Dong Lifeng , Zhang Qian , Dong Hongzhou , Li Chengdong , Tang Hongyan
Published: February 2016

Novel plate-stratiform nanostructured Bi12O17Cl2 was studied with its visible-light photocatalytic performance. The Bi12O17Cl2 photocatalyst synthesized by a solid-state reaction was constructed of dozens of primary nanosheets, which were stacked by a parallel array of ultrathin secondary nanosheets. The microstructure and crystal structure of Bi12O17Cl2 primary and secondary nanosheets were discovered by high-resolution transmission electron microscopy and selected-area electron diffraction analyses. Its absorption edge was determined as about 590 nm and the band gap energy was 2.1 eV. The Bi12O17Cl2 nanomaterial exhibited superior visible-light-responsive photocatalytic activity and confirmed successful photodegradation of methyl orange (MO) under visible-light irradiation. The degradation efficiency was up to 97% in 90 min. Furthermore, the Bi12O17Cl2 photocatalyst exhibited excellent photostability and high mineralization capacity for MO photodegradation reaction. The MO photodegradation process was dominated by the direct photocatalytic mechanism. The contribution from its morphology and microstructure to superior photocatalytic activity was discussed.
Neutron and X-ray powder diffraction study of skutterudite thermoelectrics
Authors: Wang H. , Kirkham M. J. , Watkins T. R. , Payzant E. A. , Salvador J. R. , Thompson A. J. , Sharp J. , Brown D. , Miller D.
Published: February 2016

N- and p-type filled-skutterudite materials prepared for thermoelectric power generation modules were analyzed by neutron diffraction at the POWGEN beam line of the Spallation Neutron Source (SNS) and X-ray diffraction (XRD). The skutterudite powders were processed by melt spinning, followed by ball milling and annealing. The n-type material consists of Ba–Yb–Co–Sb and the p-type material consists of Di–Fe–Ni–Sb or Di–Fe–Co–Sb (Di = didymium, an alloy of Pr and Nd). Powders for prototype module fabrication from General Motors and Marlow Industries were analyzed in this study. XRD and neutron diffraction studies confirm that both the n- and p-type materials have cubic symmetry. Structural Rietveld refinements determined the lattice parameters and atomic parameters of the framework and filler atoms. The cage filling fraction was found to depend linearly on the lattice parameter, which in turn depends on the average framework atom size. This knowledge may allow the filling fraction of these skutterudite materials to be purposefully adjusted, thereby tuning the thermoelectric properties.
Study ofAandBsites order in lanthanide-doped lead titanate ferroelectric system
Authors: Pentón-Madrigal A. , Mendez-González Y. , Peláiz-Barranco A. , Calderón-Piñar F. , de Oliveira L. A. S. , Belhadi J. , Gagou Y.
Published: February 2016

Pb0.88Ln0.08TiO3ferroelectric system, whereLn= La, Sm, Eu, and Dy, has been characterized using Scanning Electron Microscopy, Raman spectroscopy, and X-ray diffraction experiments. Softening of the lowest transverse optical phonon modeE(1TO) was evaluated as a function of the rare earths’ ionic radius suggesting partial occupation of lanthanide ions at theAandBsites of the perovskite structure. Using Rietveld refinements, it has been established a higher incorporation of Ln3+ions into theAsites of the perovskite structure than that of theBsites for the studied ceramics. The occupation atBsites increases slightly with the decreases of the ionic radii of the lanthanides.
Human Rights and Cultural Difference: Middle Eastern Perspectives
Authors: Zubaida Sami
Published: February 2016

The idea of a universal doctrine of human rights is currently under attack in the name of cultural particularism and difference. Political leaders in China, Indonesia and Singapore have rejected Western expressions of concern about violations of human rights by their governments, with the argument that Western conceptions of human rights are not universal but culturally specific to the West, and the effort to impose these ideas on others is no less than arrogant cultural imperialism and interference in the affairs of sovereign states. In the Muslim world, too, we hear rejections of Western notions of human rights as culturally specific and the assertion that Islam has its own concepts of rights (which, for a believer, are universal). In this essay I shall explore some of the issues raised in this regard, with examples drawn mainly from Egypt and the Arab world, but which have obvious implications for current concerns in Turkey. I should make it clear at the outset that there is no one Islamic position on this issue, but many. In the Arab world, but more specially in Turkey, there are many Muslim thinkers and activists who have produced Muslim formulations of rights which are not different from the universal ideals.
Packaging Islam: Cultural Politics on the Landscape of Turkish Commercial Television
Authors: Öncü Ayşe
Published: February 2016

Scholars of Islam in Turkish society have written penetrating analyses on the reciprocal influences and complementary relationships, as well as rivalries between, Alevi Islam, Sunni Islam, Islam of the Sufi orders, Islam of student activists, Islam of “Islamist intellectuals”, Islam as embedded in the oral culture and daily practices of the “mahalle”, Islam of the scriptures, and so on. There are clearly different ways of knowing Islam, distinct yet intertwined. My concern in the present study is with a particular knowledge of Islam—as constructed on the landscape of commercial television in Turkey.
The Shaping of a Nation: Palestinians in the Last Century of Ottoman Rule
Authors: Migdal Joel S. , Kimmerling Baruch
Published: February 2016

No period was more decisive in the modern history of Palestine than the British Mandate, which lasted from the end of World War I until 1948. Not only did British rule establish the political boundaries of Palestine, the new realities forced both Jews and Arabs in the country to redefine their social boundaries and self-identity. But the cataclysmic events that continued through 1948, with the creation of Israel and what Arabs called al-Nakba (the catastrophe of dispersal and exile), took shape in the wake of key changes stretching over the last century of Ottoman rule. What was to be Palestine after World War I became increasingly more integrated territorially during the nineteenth century. And Arab society in the last century of Ottoman rule underwent critical changes that paved the way for the emergence of a Palestinian people in the twentieth century.
National Events and the Struggle for the Fixing of Meaning: A Comparison of the Symbolic Dimensions of the Funeral Services for Atatürk and ÖZal
Authors: Seufert Günter , Weyland Petra
Published: February 2016

On April 17, 1993 the Turkish President, Turgut Özal, suddenly died, leaving the Turkish nation in a state of shock and mourning. This situation lasted for almost a week, a time full of nationwide, activities in preparation for the final services which eventually were to culminate in the state funeral. It was only after this that Turkish society returned to normal everyday life, to watch its politicians haggling over Özal's political heritage. As outsiders to Turkish society living in Istanbul at that time we became participant observers of this atmosphere of rising collective solemnity. It was the symbolic dimension of the funeral preparations and the final services which principally aroused our interest, and these are, therefore, the main reason and focus of this article. As festivities always have a reference to the self-understanding of a community or a nation, we analyzed those images and signs which reached us through reading newspapers, watching TV, listening to the radio and the people, and through personal participation in the funeral service in Istanbul. Insofar as we conceptualized Özal's funeral as a collective ceremony that both mirrored and created this society's self representation, our focus gradually broadened. Proceeding on the assumption that the comparison of two similar events at different historical moments of a society will allow us to get an insight into the development of a society’s self understanding over time, we have chosen the funerals services for Mustafa Kemal, the founder of the republic, as just such a point of reference. This will give us an insight into the development of Turkey’s great political tradition, or, more precisely, into the changing construction of national identity on the part of the political elite. In choosing the funeral service of Kemal Atatürk as such a point of comparison we do so first of all because until today Turkish state and society have been deeply characterized by and identified with this leader's legacy, and consequently any change can only be measured by taking Kemalism as a point of reference.
Becoming The “Other” as a Muslim in Turkey: Turkish Women vs. Islamist Women
Authors: Saktanber Ayşe
Published: February 2016

The covering of women has become the mark of Islam's new visibility in urban Turkey since the 1980s. Women wearing long, loose overcoats and headscarves tightly framing their faces and covering their necks and bosoms are now a familiar part of the urban scene, as well as of university campuses. They are usually referred to asİslamci(Islamist) women, sometimes also asdinci(religionist),gerici(regressive),irticacı(reactionary),kara peçeli(black veiled)or türbanlı(turbaned). Thus in the lexicon of Turkish identity, these women constitute a group defined through oppositional terms, similar to such ephitets as “leftist” women and “femininist” women. The words “Kemalist” and/or “Atatürkist” women have concurrently gained new political significance in denoting women (often professional elites) who, as against the so-called Islamist women, proclaim their allegience to Atatürk andhisprinciples, i.e. speak from a pro-western, pro-state, secular-nationalistic and gender egalitarian position.
The Role of People'S Houses in the Making of National Culture in Turkey
Authors: Öztürkmen Arzu
Published: February 2016

Scholars engaged in the study of nationalism have often stressed an analytical distinction between the rise of nationalism and the growth of nations since nationalism, by its very nature, has always preceded the nation (Anderson, 1983; Gellner, 1983; Smith, 1983; Hobsbawm, 1990). In the case of Turkey, the rise of nationalist movements rooted in Ottoman Turkism has been well-documented by studies focussing on their pioneering leaders, publications and institutions. Efforts aimed at the making of a Turkish nation, however, coincided with the period following the establishment of the Turkish nation-state. This new phase of Turkish nationalism differed from the preceding nationalist movements of the late Ottoman era, in its concern with the consolidation of a form of its own. It borrowed elements from, but also deviated from, the expansionist, pan-Turkist tendencies of the earlier era.